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Objective:To investigate the clinical value of serum cystatin C(Cys C) and neutrophil gelatinase associated lipocalin(NGAL) combined with cardiac biomarkers in the evaluation of sepsis with renal injury in children.Methods:The clinical data of 130 children with sepsis(67 cases in sepsis non AKI group and 63 cases in septic AKI group)admitted to pediatric intensive care unit(PICU) at Hunan Children′s Hospital from May 2018 to December 2019 were retrospectively analyzed.The differences of serum Cys C, NGAL and cardiac related biomarkers between sepsis and septic kidney injury were analyzed and compared.Results:The levels of serum Cys C, NGAL and amino-terminal pro-brain natriuretic peptide(NT-proBNP) in children with septic AKI were significantly higher than those in children of sepsis non AKI group(all P<0.01). There were no significant differences in creatine kinase isoenzyme(CK-MB)and high-sensitivity troponin T(cTnT-hs) between two groups (all P>0.05). The levels of CK-MB, cTnT-hs, NT-proBNP, Cys C and NGAL in the dead children were significantly higher than those in the surviving children ( P<0.05). In terms of predicting of AKI, the area under the ROC curve of NGAL, Cys C and NT proBNP were 0.724, 0.759 and 0.747, respectively.Regarding predicting the survival and death of sepsis, the area under the ROC curve of NGAL, Cys C and NT proBNP were 0.719, 0.722 and 0.769, respectively.In predicting the prognosis of children with sepsis and kidney injury, the area under the ROC curve of NGAL, Cys C and NT proBNP were 0.683, 0.651 and 0.682, respectively.The binary Logistic regression equation was established by Cys C, NGAL and NT-proBNP, Y=0.970 NGAL+ 0.9441 BNP+ 1.815 Cys C-2.944.In predicting kidney injury, evaluating prognosis of sepsis and predicting prognosis of sepsis with kidney injury, the area under ROC curve of new variable Y were 0.882, 0.802 and 0.808, respectively. Conclusion:NGAL, Cys C and NT-proBNP can be used to judge sepsis and sepsis with kidney injury alone.The evaluation value of combined detection of three indexes is better than that of single index.Therefore, the combined use of the three indicators may be better to judge the condition of children with sepsis and kidney injury.
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Objective:To investigate the effect of nursing profession practice model on key competence of intravenous therapy specialized nurses.Methods:A total of 30 nurses were selected in People`s Hospital of Wanning by using professional practice model. The effect of key competence and intravenous therapy-related adverse events were evaluated.Results:Before training, the scores of professional attitude, professional theoretical knowledge, professional practical skills, critical thinking ability, and communication and coordination ability, nursing management ability, professional development ability were (2.74±0.66) points, (2.28±0.57) points, (2.62±0.48) points, (2.52±0.32) points, (2.38±0.38) points, (2.68±0.70) points, (2.32±0.48) points. After training, those scores were (4.02±0.88) points, (4.10±0.60) points, (3.97±0.61) points, (3.69±0.38) points, (3.78±0.60) points, (4.07±0.87) points, (3.86±0.69) points, the differences were statistically significant ( t values were 6.542-12.226, P<0.05). The incidence of phlebitis, transfusion reaction, transfusion leakage, unplanned extubation, catheter-related infections in 2016 were 0.28% (53/18 731), 0.17% (31/18 731), 0.19% (35/18 731), 0.05% (10/18 731), 0.33% (62/18 731), those adverse events were 0.12% (37/23 183), 0.07% (17/23 183), 0.09% (20/23 183), 0.01% (3/23 183), 0.19% (45/23 183) in 2018, the differences were statistically significant ( χ2 values were 5.466-15.074, P<0.05 or 0.01). Conclusion:Nursing professional practice model can promote the key competence of intravenous therapy specialized nurses and decrease the incidence of intravenous therapy-related adverse events.
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Objective To explore the value of spiral CT in differentiation between benign and malignant thyroid tumor.Methods CT findings of thyroid tumor confirmed by the pathology in 50 patients,were retrospectively analyzed and in comparison with the data of operation and pathology.Results There were benign tumor(n=35)and malignant tumor(n=15)in this study.All the benign tumors were thyroid adenoma.The malignant tumors included thyroid carcinoma(n=14)and lymphoma(n=1).All the cases of thyroid benign tumors demonstrated clear margin and homogeneous enhancement.Cystic area and curvilinear or mass calcification could be seen in some cases.Some characteristic signs,such as irregular tumor outline,fine discrete granular and irregular calcification,heterogeneous enhancement,invading neighbor structures and cervical lymph node metastasis,could only been seen in thyroid malignant tumors.Conclusion Spiral CT has a notable advantage in differential diagnosis between benign and malignant thyroid tumor.