Objective:To investigate clinical, laboratory examination and gene mutation characteristics of JAK2 V617F gene mutation negative essential thrombocytosis (ET) children. Methods:A total of 10 cases of JAK2 V617F gene mutation negative ET children who were treated in Hematological Oncology Center, Beijing Children′s Hospital, Capital Medical University from February 2017 to February 2019 were included as research subject and enrolled into ET group ( n=10). Median age of children was 6.8 years. There were 5 males and 5 females. Four children with secondary thrombocytopenia (ST) who received treatment in our hospital during the same period were included as control and enrolled into ST group ( n=4). Median age of children was 1.8 years. All the children were female. Blood routine, coagulation function test, bone marrow smear, bone marrow biopsy and related gene mutation test results of children in two groups were analyzed through case-control study mothod. Mann-Whitney U test was used to compare the age, results of blood routine examination, values of coagulation function, total numbers and proportions of megakaryocytes in two groups. Fisher probabilities was used to compare composition ratios of gender and clinical manifestations. This study met requirements of World Medical Association Declaration of Helsinki revised in 2013. And all clinical data of the children have been collected with informed consent of children′s guardians. Results:① Six of 10 children in ET group had neurological symptoms, including headache in 4 cases and dizziness in 2 cases. One patient had concurrent hepatomegaly. Remaining 4 cases had no obvious symptoms. Among 4 children in ST group, two cases were accompanied by fever or prodromal infection, and the other 2 cases had no obvious symptoms. ② Peripheral blood platelet count and plateletocrit (PCT) of children in two groups were significantly higher than normal reference range.Median platelet count of children in ET group was 1 451×10 9/L[(1 193-1 831)×10 9/L], which was higher than that of children in ST group, which was 966×10 9/L[(677-989)×10 9/L], and difference was statistically significant ( Z=-2.404, P=0.014). And median PCT of children in ET group was 1.28%(1.12%-1.63%), which was also higher than 0.85%(0.62%-1.05%) of ST group, and difference was statistically significant ( Z=-2.256, P=0.024). Platelet distribution width (PDW) of children in two groups were lower than the normal reference range. Among the coagulation function related indicators, prothrombin time (PT), activated partial thromboplastin time (APTT) prolongation and fibrinogen (FIB) reduction were observed in 4, 4, 4 children in ET group, while in 1, 2, 2 children in ST group, respectively. Other examination indicators of children in two groups were normal. ③ Bone marrow smear results of children in two groups showed moderate hyperplasia, and ratio of granulosa to red system was normal. In addition, left shift of neutrophil nuclei and infection-related cells were also observed in bone marrow smears of 4 children in ST group. Bone marrow biopsy results of children in 2 groups showed moderate hyperplasia and active hyperplasia, and grain red ratio was normal. Megakaryocytes were dominated by lobulated megakaryocytes. Megakaryocyte immunohistochemical staining showed that median proportion of normal megakaryocytes in bone marrow of children in ET group was significantly lower than that of children in ST group [49.5% (44.3%-61.0%) vs 71.1% (61.3%-85.0%), Z=-2.404, P=0.014]. ④ Gene sequencing showed that none of 10 children in ET group had MPL or JAK2 gene mutations, and 2 of them had CALR gene mutations, which were clearly related to ET. In addition, four gene mutations that may be associated with ET in children were screened, including KMT2A, ASXL1, CSF3R and NF1 gene mutation. Conclusions:JAK2 V617F gene mutation negative ET children have unique clinical and laboratory examination characteristics. Next-generation sequencing found mutations in KMT2A, ASXL1, CSF3R and NF1 genes that may be related to occurrence and development of ET, which can provide reference for clinical diagnosis of JAK2 V617F gene mutation negative ET. However, the number of children included in this study was small, and there was a lack of male children with ST as a control, which had certain limitations. Clinical characteristics of JAK2 V617F gene mutation negative ET children, results of relevant laboratory tests, and key points of differentiation from ST children need to be further confirmed by large-sample clinical studies.

Objective:To summarize and analyze the results of chromosome karyotype in children with neuroblastoma (NB) with bone marrow metastasis at first diagnosis, and to discuss the clinical significance.Methods:G-banding was applied to the analysis of chromosome karyotype of patients who were regularly treated in the Hematological and Oncology Center in Beijing Children′s Hospital from January 2015 to December 2017, and all the patients were followed up until December 31, 2018.Their clinical features and prognosis were analyzed.Results:(1) There were 120 cases with bone marrow metastasis, including 74 boys and 46 girls, and 98 cases (81.7%) were ≥ 18 months.Among 60 cases with normal chromosome, 56 cases (93.3%) were in International Neuroblastoma Staging System(INSS)-Ⅳ phase, and 4 cases in INSS-Ⅳs phase; there were 2 low-risk (LR) cases, 9 intermediate-risk (MR) cases, and 49 high-risk (HR) cases (81.7%); 7 cases had MYCN gene amplifications.All 60 patients with chromosome abnormalities were in INSS-Ⅳ phase; there was 1 case in MR and 59 cases (98.3%) in HR; 14 cases had MYCN gene amplifications.(2) Among 60 children (50%) with chromosome abnormalities, 4 children had number abnormalities, 14 children had structural abnormalities, and 42 children had both number and structural chromosome abnormalities.Chromosome 21, 10, 11 deletions were the most common in number abnormalities; structural abnormalities involving 11q, 1p, 3p segments had a high incidence.(3) Seventeen cases of children with normal chromosome had tumor progression or recurrence during the 4 to 44-month follow-up period, and 31 cases of children with chromosome abnormalities had tumor progression or recurrence during the 2 to 42-month follow-up period.The 3-year overall survival rate and event-free survival rate of all children were 60.0% and 48.4%, respectively; children in the normal chromosome group had a 3-year overall survival rate of 74.2% and an event-free survival rate of 65.7%; the 3-year overall survival rate and event-free survival rate of children with chromosome abnormalities were 47.5% and 24.9%, respectively.Most children suffering from tumor progression or recurrence had chromosome 10 deletion, and abnormal structure of 11q, 1p, 2p segments. Conclusion:The chromosomal abnormality rate of Nb children's tumor cells is high, but the repetition rate is low, and the individual difference is obvious.The deletion of chromosome 10, abnormal regional structure of 11q, 1p and 2p segments may be poor prognostic factors for NB.Chromosome karyotype analysis of bone marrow samples is feasible, which can provide a basis for more accurate risk stratification and treatment.

Objective:To study the etiology of vertigo in children and analyze the relationship between the etiology of vertigo and the age category. Method:One hundred and forty-four cases of children with vertigo or dizziness were selected. All patients received the vertigo questionnaire, audiological, vestibular function and other related examinations. JMP 10.0 was used for statistical analysis. Result:Of 144 patients, 17 cases were preschool age (<6 years old), 101 cases were school age (6-12 years old) and 26 cases were puberty (>12 years old). All patients were mainly distributed between 6 and 10 years old. The most common diagnoses was benign paroxysmal vertigo. The second one was vestibular migraine. Incidence rate of the same disease in different ages was also different. Benign paroxysmal vertigo and vestibular migraine in preschool age, school age and puberty accounted for 58.8%, 42.6%, 0 and 0, 17.8%, 30.8%, respectively. Conclusion:Benign paroxysmal vertigo and vestibular migraine were the most common causes of vertigo in children. Prevalence rate and the etiology was various in different ages. Due to the physical and psychological development of children, analyzing the cause of vertigo in children should be fully considered these characteristics.

目的 探讨学龄前和学龄期良性阵发性眩晕(BPV)患儿临床特征差异性.方法 选取BPV患儿48例,通过眩晕问卷调查、听力学检查、前庭功能检查,对比分析学龄前和学龄期BPV患儿在临床表现、前庭功能的特点.结果 48例BPV患儿中男22例、女26例,年龄3～12岁,中位年龄7.0岁;学龄前患儿25例,学龄期患儿23例.学龄前及学龄期患儿临床表现为恶心、呕吐率分别为35.7％ (10/28)和64.3％(18/28),平衡功能障碍率分别为85.7％ (12/14)和14.3％(2/14),伴发头痛率分别为18.2％(2/11)和81.8％(9/11),学龄前和学龄期患儿恶心、呕吐率、平衡功能障碍率、伴发头痛率比较,差异有统计学意义(P均＜0.05);辅助检查中纯音测听、声导抗、高刺激率ABR、前庭冷热气检查方面,学龄前和学龄期患儿比较,差异无统计学意义.结论 学龄前和学龄期BPV患儿在临床表现、平衡障碍、伴发头痛方面有所不同.

Objective: To investigate the clinical characteristics, prognosis and affected branches of vestibular neuritis in children. Methods: Twenty-five patients with vestibular neuritis in ENT department, Beijing Children's Hospital, from October 2015 to October 2016, were collected. All patients were 4-14 (mean 9.8) years old including 17 boys and 8 girls. The clinical manifestations history, pure tone audiometry (PTA), vestibular function tests were done for each patient. We also took the blood samples for pathogenic virus in order to analyze the premorbid risk factors. Results: Rotational vertigo were complained by all presents. There were 17 cases (68%, 17/25) with nausea and vomiting and 19 cases (76%, 19/25) with balance dysfunction. There were 12 cases (60%, 12/20) with positive results in 20 blood samples for virology, among which 6 cases of influenza B virus and 4 cases of herpes simplex virus, 1 case of cytomegalovirus and 1 case of coxsackie were identified. The results of PTA were normal. Bithermal caloric test was abnormal in 22 cases (88%, 22/25). The ocular vestibular-evoked myogenic potential (oVEMP) in 12 cases (48%, 12/25) and cervical vestibular-evoked myogenic potential (cVEMP) in 5 cases (20%, 5/25) were abnormal. The bithermal caloric test along with oVEMP and cVEMP in 4 cases (16%, 4/25) were abnormal. The bithermal caloric test and oVEMP in 7 cases (28%, 7/25) were abnormal. The bithermal caloric test in 11 cases (44%, 11/25) were abnormal. The oVEMP in 1 cases (4%, 1/25) was abnormal. The cVEMP in 1 cases (4%, 1/25) was abnormal. All patients recovered well, but the time varied. The symptoms of 21 patients were complete recovery within 1 month. 3 patients were complete recovery within 2 months (aged 8 - 14 years old). One patient was complete recovery within 6 months (aged 13 years old). Conclusion: Rotary vertigo is most commonly in children with vestibular neuritis, accompany with imbalance and vomiting. The vestibular neuritis in children might be related with upper respiratory tract infection. Audiometry test is normal. Because of the bithermal caloric test and oVEMP are obvious abnormality, therefore it is speculated that the superior vestibular nerve may most commonly be affected. The younger patients with vestibular neuritis recovered more quickly than the older children.

目的 探讨混合谱系白血病(MLL)基因重排阳性的急性淋巴细胞白血病(ALL)儿童的骨髓细胞形态特征及其与临床表现和预后的相关性.方法 回顾性收集首都医科大学附属北京儿童医院(我院)血液肿瘤中心采用中国儿童白血病治疗协作组(CCLG)ALL-2008方案治疗的MLL基因重排阳性的ALL初诊患儿(MLL+组),以我院CCLGALL-2008方案治疗且时问相近、同性别的MLL阴性的初诊ALL患儿为配对条件(MLL-组).MLL+组依据骨髓细胞中是否有嗜天青颗粒、核仁、空泡和伪足分为阳性亚组和阴性亚组.考察MLL+和MLL-组形态特征差异;比较MLL+组形态学阳性亚组和阴性亚组临床表现和无事件生存率(EFS),通过受试者工作曲线(ROC)探讨骨髓细胞不典型形态特征对患儿预后的预测能力.结果 2011年1月1日至2018年5月31日共收治MLL+组26例,其中男12例,女14例;年龄0.4～13岁,18例处于完全长期缓解状态,5例骨髓复发,3例确诊后放弃治疗.MLL-组30例,男16例,女14例;年龄0.8～14岁.MLL+组骨髓细胞形态与MLL-组比较差异无统计学意义,糖原染色阳性率和赋分值均低于MLL-组.骨髓原始、幼稚淋巴细胞核仁、嗜天青颗粒、空泡、伪足的形态特征与初诊时外周血WBC、性别、年龄无相关;6例MLL-AF4融合基因阳性者全部发现具有核仁,其他MLL重排者具有核仁的比例显著低于MLL-AF4+者,差异有统计学意义(P=0.028).无伪足患儿第33天MRD≥10-4的比例高于有伪足的患儿,差异有统计学意义(P=0.025),有、无核仁的患儿3年EFS[(55.0±15.0)％vs.100％],差异有统计学意义(P=0.049);有、无嗜天青颗粒的患儿3年EFS[(41.7±22.2)％vs.(83.9±10.4)％]差异无统计学意义(P=0.052);联合核仁和颗粒对MLL+组预后的ROC曲线分析结果显示,联合预测能力优于分别预测(AUC分别为0.833、0.786和0.705),P值分别为0.023、0.051和0.162.结论 MLL基因重排阳性ALL患儿骨髓白血病细胞具有独特的组化染色特征,其形态表现与MLL重排亚型相关,并可预测患者预后.

Objectives Through analyzing the epidemiological characters and clinical features of 215 cases of bacillary dysentery patients in the infectious department of a hospital, to make guidance for the clinical diagnosis and treatment.Methods A retrospective investigation was carried out to analyze the epidemiological and clinical features of 215 cases of bacillary dysentery patients.Results Bacillary dysentery easily occurred in summer and autumn(4-10 months a total of 204 cases, accounting for 94.88%), which is good for young people and middle-aged or older people(21 to 30,31 to 40, 51 to 60, above 60years old, a total of 181 cases, accounting for 84.19%),mainly manifested as diarrhea, abdominal pain, nausea, vomiting, fever, tenesmus, mucus purulent blood and so on, pathogen detection showed mainly shigella, early diagnosis, give anti-inflammatory, disturbance of flora, diarrhea, fever, pain, antiemetic, treatment ,clinical symptoms and signs were significantly improved. Conclusions Bacillary dysentery occurred in summer and autumn more often,young people and middle-aged or older people were easily to get the diseases,which mainly manifested as diarrhea, abdominal pain and so on. We should improve the understanding of the bacillary dysentery epidemic characteristics and clinical features of the clinical doctors, so as to improve the effect of treatment. And at the same time, we advised related disease control department to strengthen the prevention and control of bacillary dysentery, so as to reduce the incidence of bacillary dysentery.

目的 探讨儿童急性B淋巴细胞白血病(B-ALL)伴有髓系抗原(CD33和/或CD13、CD117)表达阳性与表达阴性患儿的骨髓涂片中原始、幼稚细胞形态的异同,以提高ALL形态学诊断的准确率.方法 收集经细胞形态学、免疫学、细胞遗传学和分子生物学(MICM)诊断为B-ALL的患儿124例.采用流式细胞术检测B-ALL患儿髓系抗原表达,与髓系抗原表达阳性和阴性患儿的骨髓细胞形态进行回顾性分析.结果 124例B-ALL患儿中,有43例(34.7%)CD33抗原为阳性,2例(1.6%)CD33、CD13抗原阳性,2例(1.6%)CD33、CD117抗原阳性,1例(0.8%)CD117抗原阳性.在48例髓系抗原表达为阳性的患儿中,有29例患儿骨髓涂片中的原始、幼稚细胞形态不易观察、判别,占全部患儿的23.4%,占抗原阳性患儿的60.4%.结论 儿童B-ALL伴髓系抗原表达的骨髓细胞涂片中,原始及幼稚细胞形态存在多样性及异质性,多不同于髓系抗原阴性的细胞形态,不易判别.

Objective To investigate the prognosis of grommet insertions for osecretory otitis media in children and analyze the factors that may influence the results.Methods A retrospective review of 103 children (182 ears) with grommet insertions for osecretory otitis media from January 2011 to December 2011 was performed.They were divided into two groups(A and B) basing on the median age of 6 years old and observed their clinical manifestations,etiology and prognosis through two years' follow-up.The preoperative pure tone audiometry(PTA) hearing threshold,PTA in two weeks after surgery,the proportion of adenoid hypertro phy,the time of tube extrusion,the relapse of osecretory otitis media and repeat operation between two groups were compared.Results The difference of preoperative PTA and post operative PTA were not significant different between two groups(P＞0.05).But post operative PTA was lower than preoperative PTA(P＜0.05).The difference of otitis media recurrence was not significant different between two groups(P=0.088),but adenoid hypertrophy's proportion,tube extrusion's time and relapse were significant different(P＜0.05).Conclusion For school-age children with secretory otitis media need to extend the catheter time to reduce the probability of secondary catheterization.

As the record archives of the patient's medical record activities,the writing quality had a direct impact on the accuracy of the classification of diseases. Because of unfamiliar with the coding rules of illness or surgery,problems often appeared such as incorrect selection of principal diagnosis,disagreement between discharged diagnosis and pathological diagnosis as well as inaccurate surgical operations names,which would usually cause coding errors. To improve coding accuracy,the coding personnel should strengthen the training of International Classification of Diseases related knowledge and disease diagnosis writing among clinicians,study hard clinical medical knowledge and improve their own quality and level of professional knowledge. Only the joint efforts of clinicians and medical record coding staff could we ensure the accuracy of disease classification and operation classification,as well as provide better service for medical treatment,teaching and scientific research.

Objectives To evaluate the medical treatment quality of a hospital with the application of three kinds of comprehensive evaluation methods, compare the advantages and disadvantages, and provide the basis for hospital scientific decision-making.Methods We screened 5 indicators which were the number of discharged patients, rate of utilization of hospital beds, the average length of stay, mortality and average hospitalization expenses. The three methods including TOPSIS method, the comprehensive index method and rank sum ratio method analyzed in-patient medical quality from 2010 to 2015.Results The evaluation results of TOPSIS and comprehensive index method was that in-patient medical quality was increasing year by year from 2010 to 2015. The evaluation result of rank sum ratio method was that the year of 2015 was superior, the years of 2012, 2013 and 2014 are intermediate, the years of 2010 and 2011 were subordinates.Conclusions The results of TOPSIS method and comprehensive index method were consistent. RSR method was suitable for the classified comparison.

目的 探讨骨髓检查在视网膜母细胞瘤患儿远处转移中的早期诊断价值,为进一步确定视网膜母细胞瘤(retinoblastoma,RB)患儿骨髓检查的时机提供依据.方法 回顾性分析2009年11月至2014年5月在首都医科大学附属北京儿童医院收治的经临床或病理诊断明确且临床资料完整的91例RB患儿临床资料.结果 91例进行骨髓常规检查,70例患儿同时进行了骨髓活检.其中,男性48例(52.7％),女性43例(47.3％),患儿年龄2～76个月,平均年龄25.1个月(双眼16.3个月,单眼29.0个月).在骨髓穿刺细胞学检查的91例患儿中,16例做单部位骨髓穿刺,余75例患儿均做胸骨和右髂后上棘两部位穿刺.仅8例患儿骨髓涂片幼稚淋巴细胞比例≥5％,仅l例眼外期患儿经骨髓活检证实骨髓转移,余7例患儿骨髓活检阴性.8例骨髓幼稚细胞比例≥5％的患儿随访至2016年4月25日,随访时间29～54个月,存活6例,死亡l例,失访1例.结论 眼内期D和E期RB早期骨髓转移发生率极低,骨髓检查可不作为常规检查.但当临床分期不明确,可疑眼外期RB或眼内期RB存在影像学检查高危因素时,应完善骨髓常规和骨髓活检以协助诊断,另外,RB患儿发病时年龄小,骨髓增生活跃,骨髓结果受影响较多,故不能作为确诊检查,需行骨髓活检进一步明确幼稚细胞的性质.

目的 分析杜氏肌营养不良(DMD)患儿睡眠呼吸障碍(SBD)的睡眠呼吸参数特征和危险因素.方法 回顾收集首都医科大学附属北京儿童医院确诊的DMD患儿中行多导睡眠监测(PSG)同时完成《SBD相关症状调查表》的病例,根据睡眠分期和呼吸事件,分为SBD组和非SBD组.截取重要的睡眠参数、呼吸参数和经皮二氧化碳分压(TcpCO2)监测值,对DMD患儿发生SBD行单因素和多因素分析.结果 70例DMD行PSG检查患儿进入本文分析,均为男性;非SBD组45例;SBD组25例,其中1～3岁0/12例,～6岁8/23例,～9岁12/30例,＞10岁5/5例.行PSG检查平均年龄(6.3±2.5)岁;行PSG时睡眠时间313～ 593 (457±59) min,睡眠效率:54％～98％[(86.7±8.1)％].66例PSG同时行TcpCO2监测.诊断阻塞性睡眠呼吸暂停低通气综合征(OSAHS) 14例,CO2潴留18例,同时存在OSAHS和CO2潴留7例.家长主诉存在夜间呼吸暂停现象、夜间气促或窒息、因鼻塞而张口、白天睡眠增多的比例SBD组较非SBD组多,差异有统计学意义.SBD组更容易觉醒、伴呼吸事件觉醒次数更多、整夜睡眠中浅睡眠比例较高、深睡眠比例较低和睡眠效率较低与非SBD组比较,差异均有统计学意义.除中枢性呼吸暂停次数外,余呼吸参数SBD组与非SBD组差异均有统计学意义.北极星移动评价量表(NSAA)＜ 13.5分(OR =3.4,95％ CI:1.060 ～ 10.949)和年龄≥6岁时行PSG(OR=7.3,95％CI:1.426～37.463)均增加SBD患病风险.结论 DMD患儿可在病程早期发生SBD,随年龄增长逐渐增高,NSAA评估对发现SBD有较好的提示意义.

Objective To investigate the epidemiological and clinical features of 184 cases of influenza B patients cases treated in our department, so as to guide our clinical diagnosis and treatment. Methods Retrospective investigation was carried out to analyze the epidemiological and clinical features of 184 Patients with influenza B ,statistical analysis using X2 test . Results Influenza B occurred in winter and spring(1-3 months a total of 162 cases, accounting for 88.04%), good in young people(14-20、21-30、31-40 years old, a total of 137 cases, accounting for 74.46%).The main manifestations were fever, body aches, fatigue cough and expectoration, early application of antiviral drugs, clinical symptoms and signs improved significantly. Conclusion Influenza B occurred in winter and spring,good in young people, the main manifestations were fever, body aches, fatigue cough and expectoration, according to the understanding of the epidemic characteristics and clinical features of influenza B, can effectively enhance the awareness of the prevention and control of influenza B, improve the treatment effect, at the same time Suggestions for disease control department to strengthen the prevention and control of influenza B.

Pediatric acute lymphoblastic leukemia (ALL) is the most common neoplasm and one of the primary causes of death in children. Its treatment is highly dependent on the correct classification of subtype. Previously, we developed a microarray-based subtype classifier based on the relative expression levels of 62 marker genes, which can predict 7 different ALL subtypes with an accuracy as high as 97% in completely independent samples. Because the classifier is based on gene expression rank values rather than actual values, the classifier enables an individualized diagnosis, without the need to reference the background distribution of the marker genes in a large number of other samples, and also enables cross platform application. Here, we demonstrate that the classifier can be extended from a microarray-based technology to a multiplex qPCR-based technology using the same set of marker genes as the advanced fragment analysis (AFA). Compared to microarray assays, the new assay system makes the convenient, low cost and individualized subtype diagnosis of pediatric ALL a reality and is clinically applicable, particularly in developing countries.

Objective To acquire the general characters of elderly inpatients through an analysis on the situations of elderly hospitalized inpatients of a hospital from 2012 to 2014,so as to provide the basic data for hospital medical treatment work and service for the elderly inpatients.Methods The medical records data of hospitalized patients over the age of 60 years between 2012 and 2014 were collected,then conducted retrospectively analysis on the general situation,prevalence and mortality of elderly inpatients.Results There were 46906 elderly patients in total during the three years,and the proportion of the total number of patients was 35.2%.The main diseases of elderly patients were circulatory system disease,which accounted for 29.5% of all diseases,the causes of death in elderly patients with three diseases of circulatory system disease,respiratory system disease and tumor.Conclusions Circulatory system disease was an important risk factor affecting the elderly life and health,with the increasing of the medical needs of elderly patients,hospital should provide more reasonable and adequate medical services for elderly inpatients.

Objective Through the cooperation Chinese Children′s Leukemia Group (CCLG)members,to compare the diagnosis comprehensive level of bone marrow cell morphology in child with acute lymphocytic leukemia (ALL)in these hospitals,in order to assess and standardize the cell morphology determination method,unify terminology,improve the identification ability of bone marrow cell morphology.Methods A total of 1 10 children with ALL were enrolled randomly from the hospitals of CCLG.These hospitals provided the bone marrow smear of every child with newly diagnosed,treatment for 15th d,33rd d and 12 weeks,respectively.Totally,there were 440 samples.These smears were randomly issued to 2 inspectors to reexamine.The review reports and original reports were compared and analyzed by another hematologist.Results Out of these 440 bone marrow smears,the consistent judgment was described in both review reports and original reports in 427 cases(97.0%).Of the other 13 cases (3.0%),the review reports showed the dilution of bone marrow aspiration without the description of bone marrow hyperplasia grade,but the original reports showed good aspiration of bone marrow with bone marrow hypoplasia.Good staining of bone marrow&nbsp;smear was described in both review reports and original reports in 428 cases (97.3%).Light or deep staining was showed in the other 12 cases (2.7%),but in the original reports,they showed good staining.In the procedure of describing the character of bone marrow,both the review and original reports were showed no standard terms with Sino-English language mixing,without standard Chinese and English abbreviation.The conclusions of bone marrow smear in the review and original reports were consistent in 427 cases(97.0%),except for the other 13 cases with objection in the aspiration of bone marrow between the 2 reports.Conclusions The comparison analysis of bone marrow smear in children with ALL in multicenter is a very important attempt and exploration to improve the diagnosis level of bone marrow cell morphology,establishes a standardized cell morphology determination pattern,unify terminology,and improve the report recognition degree.

Objective To build prediction linear regression model according to the number of outpatient and emergence visits and discharged patients from 2009 to 2013 in a grade 3 and first-class hospital and predict index of correlation and Compared with the actual number in 2014.Methods According to the data nearly five years,a linear regression model for outpatient visits,emergency visits and discharge number was built with calendar year.The parameters were estimated in the model.The responding figures and 95% confidence interval in the first half year of 2014 were predicted by the model.The predictive value was assessed by comparing the estimated value with the actual value.The linear graph was prepared with statistical analysis.Results Outpatient visits,emergency visits and discharge number increasing from 2009 to 2013 were statistically significant and had a positively linear regression with calendar year (P<0.05).99% variance of outpatient visits,79% variance of emergence visits and 99% variance of inpatient were depended on the change of years.The predictive value of outpatient visits,emergence visits and the discharge number were 2845144,207038,46654, respectively.The predictive value in the first half year of 2014 compared to the actual data was within 95% confidence interval. Conclusion The outpatient visits,emergence visits and the discharge number had a good linear relationship with calendar year.We could make regression model to predict outpatient visits,emergence visits and the discharge number.

针对抗菌药物的滥用情况愈加严重,卫生部将Ⅰ类切口手术围手术期预防用药作为专项整治的重点.在此项工作中需要掌握手术Ⅰ类切口的用药率、感染率等指标.文章提出信息统计部门必须准确地提取Ⅰ类切口数据,认识Ⅰ类切口数据的定义和范围.但是,现有Ⅰ类切口的统计标准已不能满足当今手术种类多样化而带来的切口分类问题.为了保障统计的准确性,文章建议管理部门必须重视分类的标准的更新,对于新技术手术的切口分类提供指导.有利于数据的准确和真实.

Objective To ensure file in time of hospitalization medical record within 24 hours after discharge from hospital,and to accurately and timely use medical record information and to avoid the loss of the medical records.Methods Discussing the common problems of medical record file by retrospective analysis.Results Continuously improve recognition of the importance of medical information of medical record management staffs and clinical doctors by optimizing medical record management process,perfecting management system,and strengthening responsibilities.