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Objective:To explore the risk factors influencing the short-term mortality of patients with sepsis in intensive care unit (ICU) and the combined value of predicting prognosis.Methods:A retrospective analysis was performed on 104 patients with sepsis admitted to emergency ICU of Jiangsu Provincial Hospital of Traditional Chinese Medicine from January 2018 to August 2019. Multiple general information containing gender, age, past history as well as complications and sequential organ failure assessment (SOFA) score, mean arterial pressure (MAP), blood routine examination, hepatic and renal function, coagulation indicators and procalcitonin (PCT) were collected within 24 hours of admission. Patients were divided into death group and survival group according to the 28-day outcome. Univariate and multivariate Logistic regression analysis were used to find the effective factors influencing the prognosis of sepsis. Receiver operating characteristic (ROC) curve was drawn to evaluate the value of related indexes in predicting the prognosis of sepsis. Correlation between parameters that might be relevant to disease severity and SOFA score was evaluated by Pearson or Spearman correlation analysis.Results:104 patients were enrolled for final analysis, of whom 60 patients survived, while the others died with a 28-day mortality of 42.3%. ① Univariate analysis results: the incidence of acute kidney injury (AKI), SOFA score, serum creatinine (SCr), D-dimer, activated partial thromboplastin time (APTT), international normalized ratio (INR) and PCT in the death group were significantly higher than those in the survival group [incidence of AKI: 70.5% (31/44) vs. 36.7% (22/60), SOFA score: 11.0 (8.0, 13.0) vs. 8.0 (6.2, 10.0), SCr (μmol/L): 108.8 (65.5, 235.6) vs. 75.1 (55.1, 109.5), D-dimer (mg/L): 4.1 (1.6, 11.6) vs. 2.1 (1.2, 4.3), APTT (s): 42.6 (37.7, 55.7) vs. 40.3 (35.9, 44.7), INR: 1.3 (1.2, 1.5) vs. 1.2 (1.1, 1.4), PCT (μg/L): 3.1 (0.4, 39.9) vs. 0.3 (0.1, 3.4), all P < 0.05]. ② Multivariate Logistic regression analysis results: all indicators of univariate analysis were included in the multivariate Logistic regression model considering interaction between each variable. Multivariate Logistic regression analysis was repeated based on conditional backward method. Age, SOFA score, MAP, neutrophil (NEU), lymphocyte (LYM) and APTT were automatically selected by SPSS software to build the predicting model. Analysis results showed that SOFA score, NEU and LYM were independent risk factors for the short-term prognosis of sepsis [SOFA score: odds ratio ( OR) = 1.22, 95% confidence interval (95% CI) was 1.04-1.44, P = 0.02; NEU: OR = 1.14, 95% CI was 1.03-1.26, P = 0.01; LYM: OR = 0.79, 95% CI was 0.66-0.95, P = 0.01]. ③ ROC curve analysis results: the above six-variable prediction model had the optimal fitting degree defaulted by SPSS. ROC curve showed that the combination of age [area under ROC curve (AUC) = 0.60], SOFA score (AUC = 0.71), MAP (AUC = 0.53), NEU (AUC = 0.59), LYM (AUC = 0.54) and APTT (AUC = 0.61) had better sensitivity (79.5%) and specificity (65.0%) as well as the maximal AUC (AUC = 0.75), which suggested that combined prediction had higher diagnostic value in predicting the short-term prognosis of sepsis.④ Correlation analysis showed that NEU, D-dimer, prothrombin time (PT), APTT, INR and PCT were positively correlated with SOFA score ( r values were 0.26, 0.28, 0.21, 0.22, 0.10, 0.38, respectively, all P < 0.05). Conclusions:SOFA score, NEU and LYM were independent risk factors for the short-term prognosis of sepsis. The combination of age, SOFA score, MAP, NEU, LYM and APTT were more accurate than any single factor in predicting the short-term prognosis of sepsis and had higher diagnostic value. NEU, D-dimer, PT, APTT, INR and PCT were correlated with SOFA score.
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Objective To establish a accurate and rapid method of loop-mediated isothermal amplification(LAMP) for detecting Legionella Pneumophila(LP) .Methods The strains of LP ,Staphylococcus aureus ,Pseudomonas aeruginosa ,Escherichia coli ,Enterobacter sakazakii ,Listeria monocytogenes ,Salmonella typhimurium ,shigella flexneri and Vibrio parahaemolyticus were selected . According to six special domains of toxicity-related mip gene on LP ,the LAMP primers(mip-1 ,mip-2 ,mip-3) were designed by using the Primer Explorer Version 4 .0 .The genomic DNA was extracted for conducting LAMP .Then its specificity ,lowest detectable limit and stability were evaluated .Results The screened primer mip-3 appeared the peak after amplification for about 10 min in the LAMP reaction system for detecting LP ,moreover the peak value was higher ;while the strains of non-LP had no amplification reaction ;the LAMP detection limit could reach 100 fg/μL .The primer mip-3 appeared the peak almost at the same time in 20 times of duplicated detection ,and its stability was good .Conclusion The established LAMP detection method has the advantages of strong specificity and high stability ,can rapidly and accurately detect LP and has large prospect of promotion and application .
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Objective To survey the working situation of community nurses and care needs of the residents in a prefecture-level city.Method One hundred and thirty-five community nurses and 338 residents were selected and investigated by self-designed questionnaire.Results Community nurses still focused on the area of nursing and treatment rather than prevention,rehabilitation, health care,health education and family planning,which need to be paid more attention to.The needs of residents on community nursing service shift from disease treatment to disease prevention and health promotion.The current community nursing service cannot satisfy residents’care needs.Conclusion Community nurses should provide demand-oriented community care to the residents, strengthen the concept of disease prevention and health promotion,and set up community health centers to be a blend of prevention, health care,rehabilitation,health education and family planning as soon as possible.
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Lacking of objective referential data resources,current domestic psychotherapeutic practice is mainly based on verbal communications and associated subjective means,which elucidates the limitations to its effectiveness including discrepancies between individual patients and low repeatability.With modern technological advancement,psychotherapeutic devices have been invented to change this situation.This paper gives review of the development in this field,and proposes a practical categorization method.Besides,further development of this area is prospected.
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Objective: The Meridian Theory is an important component and the theory basis of Traditional Chinese Medicine. Three dimensional localization is the key to research of the Meridian Theory. Imaging is a scientific and practical method for the three dimensional localization of the meridian. Methods: The methods and actuality of the intrinsic quality and localization of meridians were first introduced. Then the methods and disadvantages of electrical impedance tomography (EIT) were also re-viewed. Based on these, the advantages and disadvantages of various methods applying to localization of meridian were analy-sised. Results: A new technology, magnetic detection electrical impedance tomography (MD-EIT) has obvious advantages com-paring to other EIT methods. It can fit comfortably on the dimentional localization of the meridian. Conclusions: MD-EIT can be applied not only to locate the meridians, but also to heart and lung detection and cancer diagnosis. There is a wide range of appli-cations for MD-EIT in medicine, It has great space for development.
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Purpose: To obtain more precise Electrical Impedance Tomography, the conductivity imaging which utilizes the in-formation of magnetic field has been developed as new approaches of EIT. Methods: Analysing the basic theory and develop-ing status of MIT, MD-EIT and MREIT, the Electrical Impedance Imaging by magnetic means was proved to have more bright applicational prospect. Results: Based on different imaging methods, the Electrical Impedance Imaging by magnetic means can give more accurate conductivity distributions. Conclusions: The Electrical Impedance Imaging will be used more widely by magnetic means.