Experience on prevention and control management in PICU during the epidemic of novel coronavirus Omicron variant in Shanghai / 中国小儿急救医学

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.

Comparison of long-term macular morphology after laser retinal photocoagulation and anti-VEGF therapy and their effects on vision prognosis for type 1 ROP / 中华实验眼科杂志

Objective:To evaluate and compare the foveal microvascular morphology and central foveal thickness (CFT) after laser retinal photocoagulation and intravitreal injection of anti-vascular endothelial growth factor (VEGF) in patients with retinopathy of prematurity (ROP), and to explore the factors affecting the prognosis of vision.Methods:A cohort study was conducted.Forty children (40 eyes) aged 4-6 years, who had been treated in Peking University People's Hospital for type 1 ROP from January 2019 to December 2020, were enrolled.Optical coherence tomography angiography (OCTA), best corrected visual acuity (BCVA) and refractive status of the patients were examined.The patients were divided into laser retinal photocoagulation group and anti-VEGF group according to they received a single laser retinal photocoagulation therapy or a single intravitreal injection of anti-VEGF drugs (conbercept or ranibizumab 0.25 mg/0.025 mL) after birth.Twenty age-matched full-term healthy children (20 eyes) were enrolled as the normal control group.The FAZ area, superficial and deep foveal vessel density (VD) and CFT of the affected eyes were measured by OCTA at 4-6 years after treatment to investigate the influence of gestational age, birth weight, morphological characteristics of foveal microvessels and CFT on the prognosis of BCVA.This study protocol adhered to the Declaration of Helsinki and was approved by an Ethics Committee of Peking University People's Hospital (No.2017PHB179-01). Written informed consent was obtained from the guardians prior to any medical examination.Results:There were statistically significant differences in FAZ area, superficial foveal VD and deep foveal VD among the three groups ( F=12.321, 8.436, 5.497; all at P<0.05). The FAZ area was smaller, and the superficial and deep foveal VD of the laser photocoagulation group and the anti-VEGF group were greater than those in the normal control group, and the difference was statistically significant (all at P<0.05). The CFT of the laser photocoagulation group was (267.6±11.8)μm, greater than (259.5±12.9)μm of the anti-VEGF group and (242.4±12.3)μm of normal control group, and the CFT value of the anti-VEGF group was greater than that of the normal control group, and the differences were statistically significant (all at P<0.05). There was a strong negative correlation between the superficial foveal VD and FAZ area ( r=-0.713, P<0.05), a moderate negative correlation between the deep foveal VD and FAZ area ( r=-0.565, P<0.05), and a moderate positive correlation between gestational age and FAZ area ( r=0.485, P<0.05). Pearson correlation analysis results showed that gestational age, FAZ, superficial foveal VD, deep foveal VD, CFT were all correlated with BCVA (all at P<0.05). The effects of gestational age and FAZ on BCVA were both statistically significant ( R2=0.615, both at P<0.05). Conclusions:The morphology of microvessels in macular fovea and the prognosis of BCVA in the affected eye is similar at 4-6 years after laser retinal photocoagulation and intravitreal injection of anti-VEGF drugs for type 1 ROP.The CFT of the affected eye after anti-VEGF drug therapy is better than those after laser retinal photocoagulation.Gestational age and FAZ are the influencing factors of visual acuity after treatment in children with type 1 ROP.

Analysis of the association between different treatments and high-risk histopathologic features of bilateral retinoblastomas / 中华眼底病杂志

Objective:To evaluate the pathological features of bilateral retinoblastoma (RB) and the relationship between different treatments and high-risk histopathologic features (HHF).Methods:Retrospective series of case studies. From 1999 to 2018, 73 patients with binocular RB diagnosed by pathological examination in Department of Ophthalmology, Peking University People's Hospital were included in the study. Among them, 50 patients were male (68.5%, 50/73), 23 patients were females (31.5%, 23/73); 11 patitents had a family history of RB. The mean age at the first diagnosis was 14.8±15.6 months. The average time between first diagnosis and first intervention was 3.97±4.74 months. According to the international classification standard of intraocular RB staging, among the 73 eyes, C, D and E stages were 2 (2.7%, 2/73), 15 (20.5%, 15/73), and 56 (76.7%, 56/73) eyes, respectively. Ocular images for each patient were obtained using a wide-angle contact fundus camera during examination under general anaesthesia. The treatment protocol (globe salvaging or enucleation) depended on the result of several clinical features. Globe salvaging treatment included chemotherapy combined with local therapy such as intra-arterial chemotherapy (IAC), intravitreal chemotherapeutics injection, cryotherapy, laser, transpupillary thermotherapy and radiotherapy. If globe salvaging failed, enucleation was offered and histopathologic analysis was conducted of the enucleated eye, the ophthalmic pathologist read and evaluated the presence of HHF. Independent samples t-test was performed to compare the continuous variables. The pathological features and the relationship between different treatments and HHF were analyzed. Group difference was calculated with chi-square. Results:Among the 73 eyes, the first treatment was enucleation in 21 eyes (28.8%, 21/73); 52 eyes (71.2%, 52/73) were treated with eye protection. After enucleation, 9 cases (12.3%, 9/73) had recurrence and metastasis, and 7 cases (9.6%, 7/73) died. The intervention time of patients with recurrence and metastasis and those without recurrence and metastasis were 7.4±7.3 and 3.5±4.1 months respectively; the first intervention time of patients with recurrence and metastasis was significantly later than that of patients without recurrence and metastasis, but the difference was not statistically significant ( t=-1.561, P=0.154). The pathological examination results showed that there were 26 eyes (35.6%, 26/73) with HHF, 4 (26.7%, 15/26) and 22 (39.3%, 22/56) eyes were in stage D and E, respectively. Those who received other treatments before enucleation had lower HHF percentages after enucleation than those who did not receive corresponding treatments, but the difference was not statistically significant ( χ2=1.852, 0.074, 0.000, 1.007, 0.007, 2.729; P>0.05). Among the 26 eyes, 5 (83.3%, 5/6) and 21 (31.3%, 21/67) eyes were treated with systemic chemotherapy combined with and without IAC, respectively, and there was a significant difference in the percentage of HHF ( χ2=4.422, P=0.035). Conclusions:IAC eye-preserving therapy before enucleation has a significant effect on HHF.

Differentially expressed genes in peripheral blood of patients with dermatomyositis complicated by interstitial lung disease or malignant tumors / 中华皮肤科杂志

Objective To investigate differentially expressed genes and related signaling pathways in patients with dermatomyositis/clinical amyopathic dermatomyositis (DM/CADM)complicated by interstitial lung disease or malignant tumors.Methods From January 2017 to January 2018,27 DM/CADM patients were enrolled from Department of Dermatology,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,and divided into 3 groups according to the complications:10 with interstitial lung disease,8 with malignant tumors,and 9 without interstitial lung disease or malignant tumors.Meanwhile,7 healthy controls were enrolled into this study.High-throughput RNA sequencing was performed to screen differentially expressed genes in peripheral blood in the above 4 groups.Then,these genes were subjected to gene ontology (GO) analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis.Results Compared with the healthy controls,4 820 up-regulated genes and 137 down-regulated genes were identified in DM/CADM patients;GO analysis revealed 49 significantly enriched items in the DM/CADM patients,37 (75.5％) of which were associated with biological processes;KEGG analysis showed that differentially expressed genes were mainly enriched in infection-,tumor-and immune-related pathways in DM/CADM patients.Compared with the patients without interstitial lung disease or malignant tumors,272 up-regulated genes and 158 down-regulated genes were identified in the patients with interstitial lung disease;GO analysis revealed 157 significantly enriched items,114 (72.6％)of which were associated with biological processes;KEGG analysis showed that differentially expressed genes were mainly enriched in bacterial infection-and autoimmune/inflammatory-related pathways in the patients with interstitial lung disease.Compared with the patients without interstitial lung disease or malignant tumors,398 up-regulated genes and 68 down-regulated genes were identified in the patients with malignant tumors;GO analysis revealed 117 significantly enriched items,94 (80.3％) of which were associated with biological processes;KEGG analysis showed that differentially expressed genes were mainly enriched in glycosylation-,metabolism-and tumor-related signaling pathways in the patients with malignant tumors.Conclusions Differences existed in transcriptomes and pathways between the DM/CADM patients and healthy controls,as well as between the patients with interstitial lung disease or malignant tumors and patients without these complications.Bacterial infection-and cytokine/chemokine-related pathways were significantly enriched in the patients with DM/CADM complicated by interstitial lung disease,while those pathways related to glycosylation,protein metabolism,angtigen presentation and cytotoxic effects of natural killer cells were significantly enriched in the patients with DM/CADM complicated by malignant tumors.

Differentially expressed genes in peripheral blood of patients with dermatomyositis complicated by interstitial lung disease or malignant tumors / 中华皮肤科杂志

Objective@#To investigate differentially expressed genes and related signaling pathways in patients with dermatomyositis/clinical amyopathic dermatomyositis (DM/CADM) complicated by interstitial lung disease or malignant tumors.@*Methods@#From January 2017 to January 2018, 27 DM/CADM patients were enrolled from Department of Dermatology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, and divided into 3 groups according to the complications: 10 with interstitial lung disease, 8 with malignant tumors, and 9 without interstitial lung disease or malignant tumors. Meanwhile, 7 healthy controls were enrolled into this study. High-throughput RNA sequencing was performed to screen differentially expressed genes in peripheral blood in the above 4 groups. Then, these genes were subjected to gene ontology (GO) analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis.@*Results@#Compared with the healthy controls, 4 820 up-regulated genes and 137 down-regulated genes were identified in DM/CADM patients; GO analysis revealed 49 significantly enriched items in the DM/CADM patients, 37 (75.5%) of which were associated with biological processes; KEGG analysis showed that differentially expressed genes were mainly enriched in infection-, tumor- and immune-related pathways in DM/CADM patients. Compared with the patients without interstitial lung disease or malignant tumors, 272 up-regulated genes and 158 down-regulated genes were identified in the patients with interstitial lung disease; GO analysis revealed 157 significantly enriched items, 114 (72.6%) of which were associated with biological processes; KEGG analysis showed that differentially expressed genes were mainly enriched in bacterial infection- and autoimmune/inflammatory-related pathways in the patients with interstitial lung disease. Compared with the patients without interstitial lung disease or malignant tumors, 398 up-regulated genes and 68 down-regulated genes were identified in the patients with malignant tumors; GO analysis revealed 117 significantly enriched items, 94 (80.3%) of which were associated with biological processes; KEGG analysis showed that differentially expressed genes were mainly enriched in glycosylation-, metabolism- and tumor-related signaling pathways in the patients with malignant tumors.@*Conclusions@#Differences existed in transcriptomes and pathways between the DM/CADM patients and healthy controls, as well as between the patients with interstitial lung disease or malignant tumors and patients without these complications. Bacterial infection- and cytokine/chemokine-related pathways were significantly enriched in the patients with DM/CADM complicated by interstitial lung disease, while those pathways related to glycosylation, protein metabolism, angtigen presentation and cytotoxic effects of natural killer cells were significantly enriched in the patients with DM/CADM complicated by malignant tumors.

Double filtration plasmapheresis and immunoadsorption:new model of continuous blood purification / 中国小儿急救医学

In recent years, with the great development of knowledge in pathophysiology and the improvement of medical technologies and products,we have further deepened our understanding in the princi-ples and patterns of continuous blood purification(CBP)technology. Nowadays,experts both domestic and foreign have been advocating the application of a combined CBP,which means two or more different blood purification principles or techniques combine ( or integrate) together so we can achieve different blood purifi-cation purposes and relieve or cure diseases. This document introduced the main trend and advanced technolo-gies of CBP used in critical care medicine,such as double filtration plasmapheresis and immunoadsorption.

Investigation and analysis of community psychiatric stigma in schizophrenic patients / 中国实用护理杂志

Objective To investigate the community psychiatric stigma among schizophrenic patients, to explore the related factors. Methods A total of 480 cases of schizophrenia patients were investigated using the method of Link series of stigma scale. Results A total of 480 questionnaires were issued, 436 valid questionnaires were recovered, and the effective recovery rate was 90.83%. These 436 cases of schizophrenia patients perceived devaluation discrimination subscale scores, confidentiality, separation, withdrawal, education scores of coping style, the score of two dimensions of emotional experience showed statistically significant difference with median score 2.50 of the scale respectively (t=-8.393-7.930, P<0.01). The scores were significantly different in age, marriage, medical treatment among patients perceived devaluation discrimination score and stigma coping scores and the stigma of the emotional experience (P<0.05 or 0.01). Conclusions There was widespread stigma in community patients with schizophrenia, suggesting that mental health intervention should be taken for timely intervention.

Psychological flexibility as a mediator between type-D personality and pathological internet use in u-niversity students / 中华行为医学与脑科学杂志

Objective To explore the mediating effect of psychological flexibility in the relationship between the two dimensions of type-D personality(negative affect and social inhibition)and pathological in-ternet use.Methods 592 university students were sampled from central China district and were adminis-tered with Adolescent Pathological Internet Use Scale(APIUS),Type-D personality scale(DS14)and Ac-ceptance and Action Questionnaire-Second Edition(AAQ-Ⅱ).Results Pathological internet use(2.56 ± 0.61)positively correlated with negative affect(1.58±0.78)and social inhibition(1.96±0.61)(r=0.37, 0.25)respectively,and negatively correlated with psychological flexibility(4.69±1.15)(r=-0.40).Path a-nalysis with latent variables showed psychological flexibility partially but significantly mediated the predictive effect of negative affect and social inhibition on pathological internet use.The mediation rates were 56% for negative affect and 62% for social inhibition.Conclusion Psychological flexibility has significant incremen-tal validity beyond two dimensions of type-D personality,and partially mediated the effect of negative affect and social inhibition on pathological internet use.These results suggest the intervention focus of PIU can be psychological flexibility.

Immunonutrition:role in critical illness / 中国小儿急救医学

It has widely spread thta critical li lness is characterizedas a sat te of immunosuppression and inflammation,and patients are unable to provide their own nourishment.So it has lead to the ed velopment of un tritional support por ducts or interventions designed to enhance the host immune response and/or suppress the inflammation.But there′s still a lot of controversy about immunonutrition in critically ill patients.This pa-per reviewed the research status of immunonutrition and nutritional support products.

Study on extraction technology of Zhike oral liquid / 中国生化药物杂志

Objective To establish the best extraction technology of Zhike oral liquid.Methods Using orthogonal experiment method, total flavonoids and baicalin as evaluation index, extraction time, solvent times, extraction times as factors, the optimal extraction process parameters were selected.Results The best extraction process of Zhike oral liquid:extraction time was 1h, solvent amount was 10 times, 2 times of extraction.Conclusion The extraction process is feasible, the test result is accurate and reliable, which can provide the experimental basis for the extraction process of Zheke oral liquid.

Infection control in prevention of infections of PAT parturients with cervical incompetence / 现代临床护理

Objective To explore the role of infection control in preventing infections in pregnancy-at-term(PAT)parturients with cervical incompetence. Method The strategies of infection control for 80 PAT parturients with cervical incompetence were enforced,including enhanced disinfection of hands,wards,cunnus,intensified care to skin,limited examinations of anus and pubes and prevention of complications. Results All the parturients and their babies were well and safe with one exception,who developed with infection but were cured and discharged by anti-infection managements,complement of energy and increase of nutrition intake. Conclusion Infection control may prevent the infections in PAT parturients with cervical incompetence,enhance the perinatal quality and ensure the safety of mothers and babies.

Comparative study of wild and cultivated astragali radix in Daqingshan district in Wuchuan of Neimenggu / 中国中药杂志

<p><b>OBJECTIVE</b>To make a comparative study on wild and cultivated Astragali Radix in Wuchuan, Neimenggu where is one of the geo-authentic producing areas of Astragalus membranaceus var. mongholicus.</p><p><b>METHOD</b>This comparative study focus on shapes and properties, microscopic features of transverse section and powder of roots, qualitative evaluation of wild and cultivated Astragali Radix.</p><p><b>RESULT</b>Wild Astragali Radix had a cylindrical main root, 2 or 3 root branches, dark brown color and many lenticels on the root bark. Cultivated Astragali Radix had a long cylindrical root, few root branches, yellowish white or light brown and fewer lenticels on the root bark. The differences of microscopic features were that the number of cork cells layers in wild Astragali Radix was bigger than that in cultivated Astragali Radix; stone cells were only observed in wild Astragali Radix; distinct annual rings in the xylem were only existed in cultivated Astragali Radix. The results of qualitative evaluation reveal that the contents of major active isoflavonoids and saponins in wild Astragali Radix are higher than those in cultivated Astragali Radix.</p><p><b>CONCLUSION</b>There are some diagnostic differences in the main microscopic features of transverse section and powder between wild and cultivated Astragali Radix. The contents of major active isoflavonoids and saponins in wild Astragali Radix are higher than those in cultivated Astragali Radix. Our study provides important scientific evidence for reasonable and effective uses of wild and cultivated Astragali Radix in Wuchuan, and also provides a reliable basis for the quality control of Astragali Radix.</p>

The application of objective structured clinical examination in the graduation practice examination of undergraduate nursing students / 中国实用护理杂志

Objective To summarize the principle and structure of objective structured clinical examination(OSCE)in the graduation practice examination of undergraduate nursing students.Methods A OSCE model was designed with a case running through the whole process of it by referring to the classic model of OSCE and applied it to the graduation practice examination of undergraduate nursing students of grade 2004.Results 75.0%students believed that the setup of OSCE location was reasonable and 78.1%of them thought that they were used to this kind of examination.100.0%of them considered that this examination model could objectively evaluate the general clinical capacity and at the same time make clear the future purpose of next internship stage. Conclusion The OSCE model could objectively evaluate the general clinical ability of students and truly reflect the existing problems,thus provide benefitable reforrences for the next internship stage.

Buhuangjin Zhengqi Powder Treat Chronic Gastritis of Splenic-gastric Wet Heat Syndrome / 浙江中医药大学学报

[Objective] To observe the cure effect of Buhuangjin Zhengqi Powder(BZP)on chronic gastritis of splenic-gastric wet heat syndrome.[Method] Randomly divide 100 cases into treatment group(1)with BZP and control group(2)with Mosapride for comparison.[Result] The tongue moss change of group 1 was much better than group 2,so was cure effect.[Conclusion] Revised BZP has definite effect on the said disease.