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OBJECTIVE To explore the intestinal absorption characteristics of saikosaponins. METHODS Based on everted intestinal sac model， using accumulative absorption amount （Q） and absorption rate constant （Ka） as indexes， UHPLC-MS/MS technique as a method， the absorption of saikosaponin A， B2， C， D and F from total saponins of Bupleurum chinense （8 g/mL， by crude drug） in the duodenum， jejunum and ileum was detected. RESULTS The correlation coefficients （r） of the regression equations for the absorption of saikosaponins A， B2， C and F in the duodenum， jejunum and ileum were all higher than 0.95， while the r of saikosaponin D in the above intestinal segments was lower than 0.95； compared with the absorption of the same composition in the duodenum， the Q and Ka of saikosaponin A and C circulating in jejunum and ileum for 120 min， as well as the Q and Ka of saikosaponin F circulating in the ileum for 120 min were significantly decreased （P＜0.05）. CONCLUSIONS Saikosaponin A and the other 4 saikosaponins are all absorbed in the duodenum， jejunum and ileum； among them， saikosaponin A， B2， C and F are linearly absorbed， which conforms to the zero-order absorption characteristics， but saikosaponin D shows non- linear absorption.
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Diabetic retinopathy （DR） is one of the most important microvascular complications of diabetes mellitus， which can lead to blindness in severe cases. Both traditional drug therapy and surgical treatment have certain limitations. Literature review indicates that the main pathogenesis of DR is related to inflammation and apoptosis induced by oxidative stress， and changes in growth factors， hormones， etc. Monomer of traditional Chinese medicine （chlorogenic acid）， single medicine （Panax notoginseng， Typha angustifolia， Pueraria montana root， Matrimony vine， etc.）， prescription （modified Buyang huanwu decoction and Liujunzi decoction， modified Xuefu zhuyu decoction， Simiaoyong’an decoction， etc.） and Chinese patent medicine （Ligustrazine injection， Furong tongmai capsule， Qiju dihuang pill， etc.） can provide beneficial supplement for the treatment of DR. Its mechanism of action mainly involves antioxidant， anti-inflammatory， anti-apoptosis， decreasing the expression of vascular endothelial growth factor， improving hormone levels and so on.
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Objective:To explore the predictive value of low-dose biphasic (inspiratory and expiratory) CT air trapping sign and semi-quantitative score in predicting abnormal blood gas parameters and progression to severe disease in COVID-19 patients.Methods:Patients with non-severe COVID-19 who were diagnosed by nucleic acid testing and hospitalized in designated hospitals in Wuxi City from January 23 to February 29, 2020 were prospectively and consecutively recruited. All patients received low-dose biphasic CT examination on admission and repeated CT examination at regular intervals during the course. On the inspiratory phase admission of the bipolar CT, the scope of the lesion was evaluated by semi-quantitative score, and the air trapping sign on bipolar CT was assessed. The differences of semi-quantitative score, the presence of the air trapping sign and other clinical factors were compared between the patients with abnormal and the normal blood gas index, as well as between the cases progressed to severe disease and cases without disease progression using the independent sample t-test or χ 2 test. The area under the curve (AUC) of receiver operating characteristic (ROC) and the comprehensive discriminant improvement index (IDI) were used to evaluate the predictive effectiveness of the semi-quantitative scores, air trapping sign, and combination of two factors in differentiating cases with abnormal and normal blood gas indexes, as well as in differentiating cases with and without disease progression to severe COVID-19 cases. Results:In total 51 non-severe COVID-19 cases were included, with 16 cases showed air trapping sign during the first biphasic CT examination on admission. During the course of the disease, there were 13 patients with abnormal blood gas index, and 9 cases displaying air trapping sign (9/13). All 7 cases with progression to severe cases showed air trapping sign (7/7). Patients with advanced age, air trapping sign and higher semi-quantitative score were found more likely to have abnormal blood gas index ( t=3.10, χ 2=9.38, t=3.34, P<0.05); patients with advanced age, underlying diseases, air trapping sign and higher semi-quantitative score were more likely to develop into severe disease ( t=2.68, χ 2=6.65, χ 2=4.25, t=4.33, P<0.05). The AUC of semi-quantitative score, air trapping sign and combination of two factors in distinguishing abnormal blood gas index from normal blood gas index was 0.803, 0.754 and 0.794 respectively. The AUC of semi-quantitative score, air trapping sign and combination of two factors in distinguishing cases with progression to severe cases from non-progression was 0.881, 0.898 and 0.932, respectively. Air trapping sign combined with semi-quantitative score significantly improved the prediction effectiveness of disease progression, compared with semi-quantitative score or air trapping sign (IDI=0.271, 0.117). Conclusion:Air trapping sign and semi-quantitative score might be used as effective indicators to predict the progression of COVID-19 cases, and the combination of these two factors might be more helpful to predict the disease progression.
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Objective:To explore the effect of esophageal squamous cell carcinoma-related long non-coding RNA (lncRNA) ESCCAL-1 on the polarization of THP-1 cells-derived macrophages.Methods:The esophageal cancer cell line KYSE450 was divided into 5 groups: KYSE450 group (normal KYSE450 cells), shRNA-ESCCAL-1 group (infected with knockout ESCCAL-1 lentivirus), shRNA-NC group (infected with interference control lentivirus), OE-ESCCAL-1 group (infected with overexpressing ESCCAL-1 lentivirus) and OE-NC group (infected with overexpressed control lentivirus). The expression of ESCCAL-1 was detected by real-time quantitative polymerase chain reaction (qRT-PCR). After co-culture of cells in each group with THP-1 cells-derived macrophages, flow cytometry was used to detect the expressions of THP-1 cells-derived macrophages M1 polarization markers HLA-DR, iNOS, CD86 and M2 polarization markers Arg-1, CD163, CD206, and inflammatory cytokines.Results:After THP-1 cells were stimulated with 100 ng/ml phorbol ester for 48 hours, the cells grew adherently, and the expression levels of CD11b and CD36 increased, indicating that THP-1 cells were successfully differentiated into macrophages. After THP-1 cells-derived macrophages were co-cultured with esophageal cancer KYSE450 cell line treated differently for 24 hours, there were no significant differences in the expressions of M1 polarization markers HLA-DR, iNOS and CD86 between shRNA-ESCCAL-1 group and shRNA-NC group or between OE-ESCCAL-1 group and OE-NC group (all P > 0.05). Compared with shRNA-NC group, the expressions of M2 polarization markers Arg-1, CD163 and CD206 in shRNA-ESCCAL-1 group decreased [8.54±0.29 vs. 11.83±0.69, 12.0±0.3 vs. 24.5±0.8, 2.05±0.23 vs. 14.54±1.10], and the differences were statistically significant ( t values were 7.636, 27.38 and 19.31, all P < 0.01); compared with the OE-NC group, the expressions of M2 polarization marker Arg-1, CD163 and CD206 in OE-ESCCAL-1 group increased [32.60±1.14 vs. 14.20±0.20, 43.7±1.5 vs. 25.1±1.2, 35.8±0.7 vs. 13.6±0.6], and the differences were statistically significant ( t values were -27.58, -17.24 and -43.98, all P < 0.01). Compared with shRNA-NC group, the expression level of interferon-γ in shRNA-ESCCAL-1 group decreased [(6.3±1.5) pg/ml vs. (20.0±2.6) pg/ml, t = 7.75, P = 0.001]; compared with OE-NC group, the expression level of interleukin-1RA in OE-ESCCAL-1 group increased [(3 167±306) pg/ml vs. (467±176) pg/ml, t = -13.27, P < 0.01]. Conclusions:Esophageal squamous cell carcinoma-related lncRNA ESCCAL-1 can promote the M2 polarization of macrophages.
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Objective:To explore application value of logotherapy-based intervention on palliative care for middle aged patients with advanced lung cancer, in order to provide reference for assistant of their hospice.Methods:Totally, 72 middle aged patients with advanced lung cancer from October 2018 to April 2019 in the Affiliated Brain Hospital of Nanjing Medical University, Nanjing Chest Hospital were divided into experimental group and control group according to the patients enrolled time, with 36 cases in each group. The patients in the control group recieved routine nursing, the experimental group carried out 3 times of logotherapy based on the routine nursing. Before and after intervention, the effects was assessed by Functional Assessment of Cancer Therapy-General (FACT-G), Functional Assessment of Chronic Illness Therapy-Spiritual (FACIT-Sp-12) and Hospital Anxiety and Depression Scale (HADS), respectively.Results:There was no significant difference in FACT-G, FACIT-Sp-12, HADS before intervention between the two groups( P>0.05). After intervention, the sociafamily condition, emotional condition demension scores and total scores in FACT-G were (12.75±3.55), (13.41±2.61), (43.31±4.23) points, the belief, meaning, peace demension scores as well as total scores in FACIT-Sp-12 were (11.78±1.58), (11.06±2.27), (10.19±2.33), (33.03±3.46) points in the experimental group, significantly higher than those in the control group (10.88±3.12), (11.45±3.06), (38.82±5.06), (9.73±1.39), (9.67±1.73), (8.70±2.24), (28.09±2.89) points ( t values were 2.260-6.259, P<0.05), the anxiety, depression subscale and total HADS scores were (9.19±2.36), (8.56±1.98), (17.75±3.12) points in the experimental group, significantly lower than those in the control group (10.42±1.84), (9.97±2.19), (20.39±2.50) points, the differences were statistically significant (t values were 2.352-3.776, P<0.05). Conclusions:Logotherapy-based intervention can promote quality of life and spiritual comfort and allivate nagetive emotion of middle aged patients with advanced lung cancer.
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Objective:To evaluate the prognostic value of extravascular lung water index (EVLWI) , soluble intercellular adhesion molecule-1(sICAM-1) and Krebs yon den lungen-6 (KL-6) in severe pneumonia patients with Severe Acute Respiratory Syndrome (ARDS).Methods:A prospective study was conducted in Respiratory Intensive Care Unit of the Affiliated Zhengzhou Central Hospital of Zhengzhou University from October 2017 to February 2020. The study included 65 severe pneumonia patients with ARDS, who was performed by measurement of pulse index continuous cardiac output and survived more than 3days after admission. The Extravascular Lung Water Index (EVLWI) , sICAM-1, KL-6 and Oxygenation Index(OI) on 1st, 3rd and 5th day were detected. APACHEⅡ score, patient survival events (days) and survival outcome were recorded. Correlation analysis between EVLWI, sICAM-1, KL-6 and OI was performed on the 1st, 3rd and 5th day after admission. Independent risk factors of mortality in severe pneumonia patients with ARDS were analyzed by multiple logistic regression. Receiver operating characteristic curve was drawn, and the prognostic value of each parameter was assessed finally.Results:The PCT, EVLWI, sICAM-1, KL-6 and APACHEⅡ score in the death group were significantly higher than those in the survival group ( P<0.05) at RICU admission, and the length of RICU stay was significantly shorter than that in the survival group ( P<0.05), while differences in other clinical characteristics between two groups were not statistically significant ( P>0.05) . These parameters including levels of EVLWI, sICAM-1, KL-6, Procalcitonin and APACHE Ⅱscore in the death group were significantly higher than those in the survival group on the 1st, 3rd and 5th day ( P<0.05), whereas the OI was significantly lower than that of the survival group on the 3rd and 5th day ( P<0.05). Logistic regression analysis showed that EVLWI, sICAM-1, KL-6 level were significantly related with the mortality of these patients. The levels of sICAM-1, kl-6 and EVLWI on 1st, 3rd and 5th day after RICU admission showed a significant negative correlation with OI ( P<0.001). Whereas, The levels of sICAM-1, kL-6 on 1st, 3rd and 5th day showed a significant positive correlation with EVLWI ( P<0.001). The sensitivity and specificity of sICAM-1, KL-6 combined with EVLWI in prognosis evaluation on 1st, 3rd and 5th day were 75.0%, 84.4%, 85.0%, 66.7%, 80.0%, 86.7%, respectively. The AUC was 0.864, 0.881, 0.892 on 1st, 3rd and 5th day, respectively ( P<0.001), which had a better prognostic value than each of them. Conclusions:EVLWI, sICAM-1 and KL-6 were independent risk factors for the prognosis of severe pneumonia patients with ARDS. The combination of EVLWI, sICAM-1 and KL-6 might be important in early predicting the prognosis of the 28d mortality.
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Objective:To establish the core competency index system for emergency rescue of infectious diseases among military advance nurses, so as to provide a reference for evaluating the core emergency capability of military advanced nursing staff.Methods:The index system of emergency core competence of military advanced nursing staff in the emergency of infectious diseases was preliminarily formulated. Based on the evidence-based theory, the improved Delphi correspondence method was used to issue two rounds of questionnaires to 20 authoritative experts. After sorting out and analyzing, the effective questionnaire was formed, and the weight of each index was calculated by AHP.Results:The recovery rates of the two rounds of expert questionnaire were 100%, and the expert authority coefficients were 0.792 and 0.846, respectively; the Kendall ′s W was close to 1, which was statistically significant ( P < 0.01). Finally, three first-class indicators, 12 second-class indicators and 52 third-class indicators were determined, including knowledge related to the prevention of sudden infectious diseases, professional nursing skills and medical support capacity. Conclusion:The results show that the index content of the core emergency rescue capability system of military advanced nursing staff is centralized, the weight distribution is reasonable and has high practicability, which is conducive to improve the practical technical ability and core emergency ability of the military advanced nursing staff, improve the emergency rescue level of infectious disease emergencies and the overall medical support level of military hospitals
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Objective:To construct the index system of the core competence of nursing emergency personnel in the case of infectious disease outbreak, and to provide reference basis for the assessment and training of the core competence of nursing emergency personnel.Methods:Based on the core competence indicators of nurses defined by the International Nurses' Association and the action framework of WHO's outbreak of infectious diseases as the theoretical framework, the item pool was summarized through semi-structured interviews and research group meetings, the Delphi expert letter consultation method was used to construct the indicator system, and the analytic hierarchy process and the average distribution method were used to determine the weight of indicators at all levels.Results:Two rounds of Delphi expert letter consultation, 36 questionnaires were issued in each round, and the effective recovery rate was 86% (31) and 92% (33), respectively.Finally, it was determined that the core competence index system of nursing emergency personnel for infectious disease emergencies included 5 first-level indicators, 13 second-level indicators and 53 third-level indicators. The coefficient of variation ranged from 0 to 0.173, the weight ranged from 0.074 to 0.525, and the balanced combination weight ranged from 0.165 to 0.266.Conclusion:The index system of the core competence of nursing emergency personnel in infectious disease emergencies is comprehensive and scientific, which can provide theoretical basis for evaluating and training the core competence of nursing emergency personnel in infectious disease emergencies.
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OBJECTIVE：To establish a method for concentration determination of anlotinib in human plasma and apply it in the clinic. METHODS ：The plasma samples were pretreated by salting-out assisted with liquid-liquid extraction with ammonium acetate as salting out assistant and acetonitrile as solvent. Using voriconazole as internal standard ，LC-MS/MS method was adopted. The separation was performed on Waters X Bridge C 18 column with mobile phase consisting of 0.2％ formic acid solution- acetonitrile（gradient elution ）at the flow rate of 1 mL/min. The column temperature was set at 40 ℃，and sample size was 10 μL. The split ratio was 3∶7. The electrospray ion source and multiple reaction monitoring mode were used for the analysis. The ion pair of anlotinib and internal standard under positive ion mode were m/z 408.3→339.3 and m/z 350.2→281.3，respectively. RESULTS ： Anlotinib showed a good linear relationship in the concentration range of 0.2-200 ng/mL（R2＞0.996 7）. The lowest limit of quantitation was 0.2 ng/mL. Intra-day and inter-day RSDs were no more than 12％ （n＝6 or n＝3）. Accuracies were 90.92％-108.00％（n＝6 or n＝3）. The average extraction recoveries were 87.51％-100.00％（RSD＜8％，n＝6）. The average matrix effects were 96.66％-99.93％（RSD＜5％，n＝6）. The plasma concentration of 3 patients with NSCLC treated with anlotinib was 8.74-65.60 ng/mL. CONCLUSIONS ：The method is simple ，accurate and specific ，and is suitable for the plasma concentration monitoring of anlotinib in NSCLC patients.
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Objective:To construct a standardized training course system for new nurses in radiology department based on their post competency.Methods:The first draft of standardized training course for new nurses in radiology department was drawn up by referring to domestic and foreign literature, expert interview and group discussion. 20 experts in radiology department from 12 third grade hospitals were consulted for two rounds by Delphi method, and the index weight at all levels was determined by AHP.Results:The standardized training course system of new nurses in radiology department based on post competency includes four first level indicators (knowledge, skills, situational decision-making, humanistic quality), 10 second level indicators and 55 third level indicators. In the second round of expert consultation, the positive coefficient of experts was 85%, 100% and the authoritative coefficient was 0.75 and 0.80 respectively; In the second round expert consultation, the harmony coefficient of the first, second and third level indexes was 0.401 and 0.493 respectively, P < 0.01. Conclusion:the standardized training course system of new nurses in radiology department based on post competency is scientific and reasonable, which can provide reference for standardized training of new nurses in radiology department.
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Objective:To summarize the nursing safety management measures of cataract surgery in the Caribbean in order to provide experience for medical assistance in the future.Methods:A retrospective study was conducted to analyze the safety factors of 344 patients (355 eyes) undergoing cataract surgery in the Caribbean. The safety management measures included: pre-investigation preparation, perfect preoperative examination, perioperative systemic disease nursing and health education, strict safety verification and operating room management.Results:On the day of operation, 2 patients were changed due to high blood pressure and blood glucose, 1 patient was rescheduled due to deviation in the understanding of surgical eyes, the completion rate of operation was 99.13% (341/344) , and 2 eyes of traumatic cataract were not implanted with intraocular lens (IOL). The success rate of operation was 99.44% (353/355) . One day after operation, corneal edema occurred in 63 eyes (17.75%) and intraocular lens shifted in 1 eye. During the follow-up period, all patients had no infective endophthalmitis, and there was no significant progress in patients with systemic disease.Conclusions:The working conditions of health care are difficult, the population of the Caribbean is aging, most of them are accompanied by serious systemic diseases, and the condition of patients is complex. Through a series of safety management measures, the operation can be carried out safely and successfully and good results can be achieved.
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Objective To investigate the relationship between histogram analysis of DCE-MRI quantitative parameters and clinical stage of nasopharyngeal carcinoma (NPC).Methods 70 patients with NPC confirmed by pathology underwent MRI examination and staging.NPC tumors were measured by full-volume ROI setting method,and the obtained DCE-MRI quantitative parameters were analyzed by histogram.Spearman correlation coefficients were obtained to evaluate the potential correlation between the DCE-MRI histogram quantitative parameters and NPC clinical stages.Results The histogram-based Ktrans (mean,10 th,75 th,90 th),Kep (mean,10 th,kurtosis),and Ve (mean,90 th,skewness)had correlation with T stage (P＜0.05,respectively).The histogram-based Ktrans (mean)and Ve (mean,90 th) showed correlation with N stage (P＜0.05,respectively).The histogram-based Kep (kurtosis)and Ve (mean)had correlation with M stage (P＜0.05,respectively).The histogram-based Kep had no correlation with N stage,and Ktrans had no correlation with M stage. The histogram-based Ktrans (mean,10 th,75 th,90 th),Kep (10 th,75 th,kurtosis)and Ve (mean,75 th,90 th)had correlation with overall stage (P＜0.05,respectively).Conclusion The histogram analysis of DCE-MRI quantitative parameters showed that the multiple parameters associated with NPC overall stages.DCE-MRI quantitative parameters non-invasively reflect the aggressiveness and progression of NPC.The histogram analysis of DCE-MRI quantitative parameters may play a role in clinical stage of NPC.
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OBJECTIVE@#To assess the association of single nucleotide polymorphisms (SNPs) of STK39 gene with response to hydrochlorothiazide among ethnic Han Chinese patients with essential hypertension.@*METHODS@#In total 118 patients with essential hypertension were recruited. All participants had received six weeks of treatment with hydrochlorothiazide 25 mg daily. Blood pressure (BP) and heart rate (HR) were measurement every 2 weeks. Genotypes of STK39 rs3754777 and rs6749447 were determined using a SNaPshot technique.@*RESULTS@#A significant difference was found in ΔSBP between individuals with rs3754777 CC, CT and TT and those with rs3754777 CC and CT-TT (P0.05). Relative risk analysis showed that STK39 rs3754777 was significantly associated with BP response to hydrochlorothiazide (OR=0.416, 95%CI=0.189-0.918, P<0.05).@*CONCLUSION@#Polymorphisms of STK39 rs3754777 may be associated with BP response to hydrochlorothiazide among ethnic Han Chinese with essential hypertension.
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Humans , Asian People , Essential Hypertension , Genotype , Hydrochlorothiazide , Polymorphism, Single Nucleotide , Protein Serine-Threonine Kinases , GeneticsABSTRACT
Objective:To explore the guiding role of blood concentration monitoring (TDM) for valproate (VPA) in the treatment of epilepsy,and provide reference for the clinical rational use. Methods:Totally 384 epilepsy patients treated with VPA alone were collected between August 2016 and November 2017 in our hospital. The serum concentrations of VPA were determined by HPLC. The relationship was analyzed between TDM and the efficacy and safety. The correlation between TDM and factors(age, dose,sex and dosage form)was assessed using binary logistic regression. Results:Among the 384 patients,272 (70.83%) ones were with an effective range of blood (50-100 μg·ml-1). The clinical efficacy within the range of effective blood concentration (50-100 μg·ml-1) and that with the plasma concentration above 100 μg·ml-1were both significantly higher than that with the plasma concentration below 50 μg·ml-1(P < 0.01). The incidence of adverse reactions with the range above 100 μg·ml-1was significantly higher than that with the range below 50 μg·ml-1and within the range of 50-100 μg·ml-1. Logistic regression analysis showed that dose and age had significant effect on the blood concentration(P < 0.05). Conclusion:The individual difference of VPA is obvious,therefore,VPA should be used in clinic based on TDM to improve the clinical effect and reduce the adverse reactions.
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Objective To investigate the correlation betw een serum 25-hydroxyvitamin D (25(OH) D) level and enlarged perivascular spaces (EPVS) in patients w ith lacunar infarction. Methods Consecutive inpatients w ith acute lacunar infarction w ere enrolled. Chemiluminescence immunoassay w as used to measure the serum 25(OH)D. Head MRI w as used to assess the severity of EPVS in the centrum ovale and the basal ganglia region (grade 1, 0-10; grade 2, 11-25; grade 3, >25). Univariate analysis w as used to analyze the differences in baseline data among the three groups. Multivariate ordinal logistic regression analysis w as used to investigate the independent correlation betw een the 25(OH)D levels and the severity of EPVS. Results A total of 194 patients w ere enrolled,96 w ere males.Their mean age w as 63.4 ±9.3 years. The mean baseline National Institutes of Health Stroke Scale (NIHSS) score w as 2.0 ±1.7. The mean 25(OH)D level w as(50.25 ±15.50)nmol/L. There w ere 112 patients (57.7%), 45 (23.2%) and 37 (19.1%) w ith EPVS grade 1,grade 2 and grade 3 in the centrum ovale,and 109 (56.2%),53(27.3%) and 32 (16.5%) w ith EPVS grade 1, grade 2 and grade 3 in basal ganglia region, respectively. Multivariate ordinal logistic regression analysis show ed that serum 25(OH)D levels w ere independently associated w ith the severity of EPVS in the centrum ovale (odds ratio 2.898,95% confidence interval 1.345-9.612; P=0.028) and basal ganglia region (odds ratio 2.688, 95% confidence interval 1.182-10.281; P=0.039). Conclusion The low serum 25 (OH) D levels are independently associated w ith the severity of EPVS in patients w ith lacunar infarction.
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Objective To evaluate the prognosis value of plasma soluble vascular endothelial growth factor receptor (sFlt-1) combined with extravascular lung water index (EVLWI) in acute respiratory distress syndrome (ARDS) complicated with septic shock caused by severe pneumonia. Methods A retrospective analysis was conducted in Respiratory Intensive Care Unit of the Affiliated Zhengzhou Central Hospital of Zhengzhou University from January 2015 to July 2017. The study included 52 severe pneumonia patients with ARDS complicated with septic shock, who was performed by measurement of pulse index continuous cardiac output (PICCO) and survived more than 3 days after admission. According to the 28-day mortality, these patients were divided into the survival group (31 cases) and the death group (21 cases). PICCO was used to record the EVLWI level. The plasma level of sFlt-1 was measured by enzyme-linked immunosorbent assay (ELISA). Acute physiology and chronic health evaluation II (APACHE II) score and sequential organ failure assessment (SOFA) score were calculated. Independent risk factors were analyzed by multiple logistic regression. Correlation analysis between plasma sFlt-1 and EVLWI and APACHE II values was performed on the 1st, 2nd and 3rd day after admission. Receiver operating characteristic curve (ROC) was calculated, and the prognostic value of each parameter was assessed. Results The blood lactate, APACHE II score and SOFA score in the death group were significantly higher than those in the survival group at RICU admission (P<0.05), and the length of RICU stay was significantly shorter than that in the survival group (P<0.05), while differences in other clinical characteristics between the two groups were not statistically significant. The levels of EVLWI, sFlt-1 and blood lactate, APACHE II score and SOFA score in the death group were significantly higher than those in the survival group on the 1st, 2nd and 3rd day (all P<0.05), whereas the PaO2/FiO2 was significantly lower than that of the survival group on the 2nd and 3rd day (all P<0.05). Logistic regression analysis showed that sflt-1 level and EVLWI were significantly related with the patient mortality. The levels of sFlt-1 on day 1, 2 and 3 after RICU admission were positively related to EVLWI and APACHE II score (all P<0.01). The sensitivity and specificity of sFlt-1 combined with EVLWI in prognosis evaluation were 89.7％, 78.2％ and 86.3％, 75.7％, respectively. The AUC of sFlt-1 combined with EVLWI was 0.875 and 0.856 on the 1st and 3rd day, respectively (all P<0.01), which had a better prognostic value than each of them. Conclusions SFlt-1 could be used as a biomarker of mortality for severe pneumonia patients with ARDS complicated with septic shock. The combination of sFlt-1 and EVLWI might be important in early prediction of the prognosis of the 28-day mortality in patients with ARDS complicated with septic shock caused by severe pneumonia.
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Objective To discuss nursing professional experience effect on medical fear and treatment compliance of children in ophthalmic ward. Methods A total of 60 cases of children patients in 5B Ophthalmic ward were selected as the control group,and another 60 cases of children patients in 9B Ophthalmic ward during the same period were set as the observation group.The control group was given routine nursing measures, the observation group was given routine nursing measures and nursing professional experience.The medical fear and the treatment cooperation degree of the two groups in three kinds of examination and treatment works: slit lamp examination, non-contact intraocular pressure measurement and eye drops were observed. Results In three kinds of examination and treatment works which were slit lamp examination, non-contact intraocular pressure measurement and eye drops, the psychological fear scores of the children in the observation group were 1.48±0.62,1.83±0.66, 1.35±0.54 respectively,and the scores of the children in the control group were 1.87±0.72,2.27±0.68,1.72±0.71 respectively.The psychological fear of the former were less than the latter,and the differences of the two groups were statistically significant (t=3.106, 3.506, 3.154, all P<0.05). The treatment cooperation degrees of the observation group in the previous three kinds of examination and treatment work were 93% (56/60),85%(51/60),97%(58/60),and the treatment cooperation degree of the control group were 80%(48/60), 60%(36/60), 85%(51/60). The observation group was better than the control group in treatment cooperation degree. The difference was statistically significant (χ2=4.615, 9.404, 4.904, all P<0.05). Conclusions Nursing professional experience can effectively reduce the psychological fear of hospitalized children in the treatment, improve the treatment compliance of the children, enhance the doctor-patient communication,and it is conducive to the smooth progress of the health care work.
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Objective To construct a neonatal intensive care unit (NICU) nurses′humanistic care ability evaluation index system based on knowledge, attitude, belief, practice model, thus to provide quantitative basis for the NICU nurses′ ability of humanistic care evaluation. Methods Through semi-structured interviews summed up the nursing care behavior item pool based on the knowledge, attitude, belief, practice model, used Delphi method to construct the NICU nurses′ humanistic care ability index system. Results The recovery rate of the two rounds were 87.5% (28/32) and 100.0% (32/32) respectively. The humanistic care ability included knowledge, belief, caring behavior and caring sense,11 secondary indicators and 30 level 3 indicators. The variation coefficient was 0.094-0.286. Conclusions This study scientificly and reliablly establish NICU nurses′humanistic ability index system, which can be used to evaluate and to study the status of NICU nurses′ humanistic care ability, and to strengthen the humanity quality education, to reduce the dispute of nurses and patients has important significance.
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Objective To expore the correlation between resting heart rate(RHR)and carotid atheroscle-rosis in middle-aged and elderly hypertention. Methods A total of 1043 middle-aged and elderly essential hyper-tention were selected and divided into 3 groups according to the RHR:< 70(Group A,n = 406),70～79(Group B,n=364),and≥80 beats/min(Group C,n=273). The patients′fasting blood-glucose(FBG),blood lipids, homocysteine (Hcy) and serum creatinine (SCr) levels were measured. Carotid artery intima-media thickness (CAIMT) and carotid artery diameter (CADIA) were measured by ultra-sonography ,and carotid artery plaques were investigated. Bi-variate correlation analysis was adopted to analyze the correlation between RHR and CAIMT , CADIA. Logistic regression analysis was employed to analyze the influential factors in carotid artery plaques. Mean-while,sub-group analysis of different ages was performed. Results The detection rates of carotid artery plaques in the Group A,B and C were 59.1％,63.7％and 69.6％respectively. Differences in detection rates of carotid artery plaques among 3 groups showed statistical significance(P<0.05). RHR(OR 1.165,95％CI 1.094～1.482,P=0.037) was a risk factor of carotid artery plaques. Significant positive correlations were found between RHR and CAIMT ,CADIA (r = 0.115 ,0.123;P = 0.005 ,0.003). Conclusions RHR was closely related with carotid artery plaques,CAIMT,and CADIA in middle-aged and elderly hypertention. RHR can be recognized as a predic-tive factor of carotid atherosclerosis in middle-aged and elderly hypertention.
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Objective To construct a neonatal intensive care unit (NICU) nurses′humanistic care ability evaluation index system based on knowledge, attitude, belief, practice model, thus to provide quantitative basis for the NICU nurses′ ability of humanistic care evaluation. Methods Through semi-structured interviews summed up the nursing care behavior item pool based on the knowledge, attitude, belief, practice model, used Delphi method to construct the NICU nurses′ humanistic care ability index system. Results The recovery rate of the two rounds were 87.5% (28/32) and 100.0% (32/32) respectively. The humanistic care ability included knowledge, belief, caring behavior and caring sense,11 secondary indicators and 30 level 3 indicators. The variation coefficient was 0.094-0.286. Conclusions This study scientificly and reliablly establish NICU nurses′humanistic ability index system, which can be used to evaluate and to study the status of NICU nurses′ humanistic care ability, and to strengthen the humanity quality education, to reduce the dispute of nurses and patients has important significance.