Objective:To investigate the characteristics and management approaches of patients admitted to the isolation wards in public general hospitals under regular epidemic prevention and control measures of coronavirus disease 2019 (COVID-19).Methods:All patients admitted to the isolation ward in Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, from May 14, 2020 to April 15, 2021 were enrolled, and the general information, illness severity, preliminary diagnosis and transfer department of the patients were analyzed.Results:Out of the 2 292 patients admitted to the isolation ward, critical patients accounted for 34.34% (787 cases), surgical system patients accounted for 80.06% (1 835 cases) and internal medicine system patients accounted for 19.94% (457 cases), fever patients accounted for 11.30% (259 cases). All patients successfully completed COVID-19 screening, and no COVID-19 patients were detected. Among the total enrolled patients, 2 201 patients were promptly transferred to the corresponding departments for further treatment, with an average transfer time of 0.55 day. The remaining 91 patients were discharged from the isolation ward with an average hospitalization stay of 1.27 days.Notably, there were no COVID-19 cross-infection occurred between patients and medical staff in the isolation ward.Conclusions:Scientific and efficient management of isolation wards ensure timely screening and effective treatment for patients, and simultaneously achieving "zero" infection for both medical staff and patients.

Objective:To explore the effect of pediatric critical illness score (PCIS), pediatric risk of mortality Ⅲ score (PRISM Ⅲ), pediatric logistic organ dysfunction 2 (PELOD-2), pediatric sequential organ failure assessment (p-SOFA) score and Glasglow coma scale (GCS) in the prognosis evaluation of septic-associated encephalopathy (SAE).Methods:The data of children with SAE admitted to the Pediatric Intensive Care Unit (PICU), Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences from January 2010 to December 2020 were retrospectively analyzed. They were divided into the survival and death groups according to the clinical outcome on the 28th day after admission. The efficiency of PCIS, PRISM Ⅲ, PELOD-2, p-SOFA and GCS scores for predicting death were evaluated by the area under the ROC curve (AUC). The Hosmer-Lemeshow goodness-of-fit test assessed the calibration of each scoring system.Results:Up to 28 d after admission, 72 of 82 children with SAE survived and 10 died, with a mortality rate of 12.20%. Compared with the survival group, the death group had significantly lower GCS [7 (3, 12) vs. 12 (8, 14)] and PCIS scores [76 (64, 82) vs. 82 (78, 88)], and significantly higher PRISM Ⅲ [14 (12, 17) vs. 7 (3, 12)], PELOD-2 [8 (5, 13) vs. 4 (2, 7)] and p-SOFA scores [11 (5, 12) vs. 6 (3, 9)] ( P<0.05). The AUCs of PCIS, PRISM Ⅲ, PELOD-2, p-SOFA and GCS scores for predicting SAE prognosis were 0.773 ( P=0.012, AUC>0.7), 0.832 ( P=0.02, AUC>0.7), 0.767 ( P=0.014, AUC>0.7), 0.688 ( P=0.084, AUC<0.7), and 0.692 ( P=0.077,AUC<0.7), respectively. Hosmer-Lemeshow goodness-of-fit test showed that PCIS ( χ2=5.329, P=0.722) predicted the mortality and the actual mortality in the best fitting effect, while PRISM Ⅲ ( χ2=12.877, P=0.177), PELOD-2 ( χ2=8.487, P=0.205), p-SOFA ( χ2=9.048, P=0.338) and GCS ( χ2=3.780, P=0.848) had poor fitting effect. Conclusions:The PCIS, PRISM Ⅲ and PELOD-2 scores have good predictive ability assessing the prognosis of children with SAE, while the PCIS score can more accurately evaluate the fitting effect of SAE prognosis prediction.

Thousands of children experience cardiac arrest in hospital each year, and only about half of them can survive to hospital discharge.Recognizing cardiac arrest in time and initiating high-quality cardiopulmonary resuscitation as early as possible is the key to improve the prognosis.During resuscitation, the longer the duration of cardiopulmonary resuscitation, the lower the survival rate.To prevent the heart rhythm from deteriorating into ventricular fibrillation, pulseless ventricular tachycardia and other malignant rhythms, timely use of adrenaline is beneficial to improve survival.For shockable heart rhythms, the recommended initial dose of defibrillation is 2 J/kg.Invasive airways can be harmful during resuscitation.For qualified medical institutions, choosing appropriate cases to perform extracorporeal cardiopulmonary resuscitation as soon as possible will improve the prognosis.After resuscitation, normal oxygen supply and normal pressure ventilation should be maintained, and physiological monitoring such as arterial diastolic pressure and end-tidal carbon dioxide should be used to guide post-resuscitation management.However, mild hypothermia treatment does not bring benefits to improve the prognosis.Imaging tests such as EEG, CT, and magnetic resonance imaging can assess the prognosis of nerves after resuscitation early, while neuron-specific enolase, S100 calcium binding protein, and somatosensory evoked potential have better predictive value, but lacking of enough clinical data.

Objective To investigate the clinical outcomes of immunocompromised (IC) children with pediatric acute respiratory distress syndrome (PARDS) in pediatric intensive care unit (PICU).Methods Fifty-six PADRS children were enrolled and the data of clinical characteristics,immunological status,complications,treatments and outcomes were collected and analyzed by using univariate and multivariate regression models.Results There were 20 children in the immunocompromised group and 36 in the control group.Immunocompromised children were older and weighted greater than the control ones (P=0.003 and P＜0.01,respectively).Peripheral blood leukocyte,neutrophil and platelet counts were significantly lower in IC group compared with control group (P=0.060,P=0.006 and P=0.023,respectively).In addition,high-frequency oscillatory ventilation (HFOV) was used less frequently in the IC group (P=0.015).The PICU mortality of the IC group was significantly higher than that of control group (P=0.003).The proportion of IC patients and the incidence of ventilator-associated lung injury differed significantly between survivors and non-survivors (P=0.003 and P=0.046,respectively).After adjusting for other confounding factors by using multivariate logistic regression analysis,IC was associated with a higher mortality (OR=6.986,95％ CI:1.812-26.930,P=0.005).Survival analysis also indicated that IC children with ARDS had lower 28-day survival rate than the non-IC children (P=0.022).Conclusions IC children with PARDS have a higher PICU mortality than children with normal immune function.Immunocompromise is an important predictor of poor outcomes in children with PARDS.

OBJECTIVE: To evaluate the bacteriostatic effect of ε-polylysine( ε-PL) on four common putrefactive bacteria including Staphylococcus aureus,Enterococcus faecalis,Pseudomonas aeruginosa,and E. coli and its effect on urine lead level. METHODS: Broth dilution method was used for the determination of the minimum inhibitory concentration( MIC) ofε-PL on the four kinds of putrefactive bacteria; the inhibitory effects of ε-PL with final mass concentration of 40. 000 mg / L on the urine sample were observed; graphite furnace atomic absorption spectrometry was used for determining the lead level in the 40. 000 mg / L( mass concentration) ε-PL solution and the urine lead level in normal healthy groups; the bacteriostatic effects of ε-PL and nitric acid were compared. RESULTS: The MIC of ε-PL on Staphylococcus aureus,Enterococcus faecalis,Pseudomonas aeruginosa,and E. coli was 40. 000 mg / L. There was no bacterial growth in the urine sample with40. 000 mg / L( mass concentration) ε-PL when urine was kept at room temperature for 24 hours to 15 days. The lead level was < 2. 0 μg / L in the 40. 000 mg / L( mass concentration) ε-PL solution. When the ε-PL with final mass concentration of 40. 000 mg / L and the nitric acid with a volume fraction of 1. 0% were respectively used as the antiseptics,the descending rates of the lead levels in the urine samples were similar,and after the urine sample was preserved for 15 days,the descending rates of the urine lead were both smaller than 10. 0% after be stored for 15 days. CONCLUSION: ε-PL can substitute nitric acid as a new natural preservative for preservation of samples for urine lead determination.

BACKGROUND:Nowadays increasing experimental findings have proved that the low-frequency pulsed electromagnetic fields (LPEMF) can induce osteogenic differentiation of a variety of stem cells in the two-dimensional scaffold. However, little is reported on the LPEMF effect on the proliferation and osteogenic differentiation of stem cells in the three-dimensional scaffold.OBJECTIVE:To investigate the effect of LPEMF on the proliferation and osteogenic differentiation of human adipose-derived stem cells (hASCs) in the 3D Insert-PCL scaffold.METHODS:Passage 3 hASCs were directly cultured in the 3D Insert-PCL scaffolds folowed by LPEMF (50 Hz, 1 mT) exposure, 2 hours per day, for continuous 14 days (experimental group) or no intervention (control group). After 7 days of culture, Live/Dead staining was used to observe cell survival. After 1, 3, 5, 7 days of culture, MTT assay was used to detect cell proliferation. After 7 and 14 days of culture, the osteogenic differentiation of hASCs was assessed through the alkaline phosphatase (ALP) staining and qRT-PCR.RESULTS AND CONCLUSION: Live/dead cell staining proved that the hASCs had a good growth in the 3D Insert-PCL scaffolds as well as a high survival rate. The absorbance values of hASCs in the two groups were increased gradualy with time, and the absorbance value in the experimental group was significantly higher than that in the control group at 1 and 3 days after culture (P < 0.05). The ALP activity in the experimental group was stronger than that in the control group at 7 and 14 days after culture. qRT-PCR findings showed that at 7 days after culture, the mRNA levels of ALP and type Ⅰ collagen were significantly higher in the experimental group than the control group (P < 0.01), while at 14 days after culture, the mRNA levels of osteopontin, Runt-related transcription factor, ALP and type Ⅰ collagen were significantly higher in the experimental group than the control group (P < 0.05). To conclude, the LPEMF exposure can promote the proliferation and osteogenic differentiation of hASCs cultured on the the 3D Insert-PCL scaffold.

Pediatric acute respiratory distress syndrome (PARDS) is one of the most severe disease in pediatric critical care medicine with high mortality.Pediatric practitioners have recognized that ARDS in children is different from ARDS in adults.In the absence of identification of these differences,however,children have been characterized as having ARDS based on the adult definitions.Therefore,the managements for PARDS were conducted without specific considerations of children,and have limitations when applied to patients.With the purpose to highlight the gaps of ARDS between children and adults,the new insights into PARDS on the epidemiology,pathophysiology,diagnosis,treatment and prognosis in the recent years were summarized.

Objective To study the influence of intraoperative use of saline and balanced salt solution on postoperative nerve function recovery in patients with brain trauma.Methods Totally 120 patients were randomly divided into the saline group and the balanced salt solu-tion group,and the postoperative nerve function recovery of the two groups were observed.Results The level of pH and HCO3 -24 hours af-ter operation in the saline group were lower than those in the balanced salt solution group (P <0.05),while the level of Cl - in the saline group was higer than that in the balanced salt solution group (P <0.05).The intracranial pressure and preoperative Glasgow coma score (GCS)of the two groups had no statistical significance (P =0.94).And the Glasgow coma score at 336 hours and 672 hours after opreation of the two groups were of statistical significance (P =0.00,P =0.03).The mortality of the saline group and the balanced solution group 28days after surgery were 15% and 10% respectively,and there was no significant difference between the two groups (P =0.58).Conclusion Saline resuscitation during surgery would lead to hyperchloremic acidosis as well as worse nerve function.However,the perfusion of balanced salt solution during the operation is more favorable to the recovery of neurological function.

Objective To investigate the clinical characteristics,distribution and drug sensitivity of pathogens causing intravenous catheter-related bloodstream infections (CRBSIs) in pediatric intensive care unit (PICU) so as to use antibiotics reasonably.Methods All patients with CRBSIs in PICU of Guangdong General Hospital from September 2009 to September 2014 were investigated and the drug resistance profiles of pathogens causing CRBSIs were also analyzed retrospectively.Results Between 2009 and 2014,there were totally 10 834 catheter days and 23 episodes of CRBSIs with an incidence of 2.1 infections per 1 000 catheter days.Catheter indwell time ＜ 7 days in 9 cases (39.1％),8 to 14 days in 10 cases (43.5％),14 to 21 days in 4 cases (17.4％).There were 13 strains (56.6％) of gram-positive bacteria,5 strains (21.7％) of gram-negative bacteria and 5 strains (21.7％) of fungi.The main pathogens causing CRBSIs were coagulase negative Staphylococci (7 strains,30.4％),Staphylococcus aureus (3 strains,13.0％),Candida albicans(3 strains,13.0％),Candida parapsilosis(2 strains,8.7％),and Enterobacter cloacae (2 strains,8.7 ％).The susceptibility to Vancomycin,Linezolid and Teicoplanin of coagulase negative Staphylococ cus such as S.epidermidis and to Imipenem,Piperacillin/Tazobactam,Cefoperazone/ Sulbactam and Amikacin of gram-positive bacteria arrived at 100.0％,respectively.The candida were 100％ susceptible to Amphotericin B,5-Flucytosine,Fluconazole and Voriconazole.Twenty-one cases (91.3％) received antibiotic treatment versus no antibiotic in 2 cases (8.7％).The average number of antibiotic kinds administered on the patients with fungal infection was 4.4,bacteria were 1.4.Ten cases (43.5％) treatment with 1 kind of antibiotic,4 cases (17.4％) with 2,4 cases (17.4％) with 3,5 cases (21.7％) with more than 3.Twenty-two cases (95.7％) cured and 1 case died (4.3％).Conclusions The major species of pathogen causing CRBSIs was coagulase negative staphylococci in PICU.It is critical for clinicians to guard against fungal infection because of prolonged catheter indwelling time and more antibiotics administered before indwelling catheter.It is effective way to prevent the CRBSIs by reasonably using antibiotics and shortening the time of catheter indwelling.Monitoring CRBSIs pathogenic bacteria distribution and drug susceptibility helps reasonable administration of antibiotics in the earlier time.

Objective To analyze the expression of Yes-associated protein and risk factors in differentiated thyroid carcinoma. Methods Clinical data of 152 patients with differentiated thyroid carcinoma and 27 cases of benign thyroid tumor from Changji Hui Autonomous Prefecture People’s Hospital of Xinjiang, were analyzed retrospectively. According to the expression levels of Yes-associated protein in differentiated thyroid cancer and benign thyroid tumor, univariate Chi-square test and multivariate Logistic regression methods were used to analyze the relationship between Yes-associated protein and gender, age, thyroid stimulating hormone(TSH) level, nodule size, capsule integrity, histological type and lymph node metastasis, in order to find out risk factors in differentiated thyroid cancer. Results The positive rate of expressed Yes-associated protein in benign thyroid tumor group was 66.7%(18/27), which was significantly higher than 31.58%(48/152) of differentiated thyroid cancer group, and the difference was statistically significant(χ2=12.127, P<0.01). Under an optical microscope, changes of Yes-associated protein were found to be mainly located in the nucleus and cytoplasm , and in benign thyriod tumor the degree of staining was deep, strong positive or moderately positive; differentiated thyroid carcinoma was lightly stained or no staining, weakly positive or negative. Chi-square test showed that the expression of Yes-associated protein was not affected by sex, age and pathological type(χ2= 0.419, 0.221, 0.315, all P >0.05); TSH level, nodule size, capsule integrity, lymph node metastasis had an impact on the expression of Yes-associated protein which was down regulated (χ2=4.020, 8.424, 4.386, 6.673, P<0.05 or<0.01). Logistic regression analysis showed that the nodule size was not a risk factor ( odds ratio , OR ) of Yes-associated protein expression (OR=1.929, P>0.05); TSH levels above 4.5 mU/L, lymph node metastasis and envelope incomplete were risk factors that down regulated the expression of Yes-associated protein (OR=2.167, 2.665, 3.048, all P<0.05). Conclusion Yes-associated protein is down regulated in differentiated thyroid cancer. Elevated TSH levels , incomplete capsule and lymph node metastasis are risk factors of Yes-associated protein down expression and differentiated thyroid cancer.