Predictive value of early lactate/albumin ratio in the prognosis of sepsis / 中华危重病急救医学

Objective:To investigate the prognostic value of early serum lactate, albumin, and lactate/albumin ratio (L/A) on the 28-day prognosis of adult patients with sepsis.Methods:A retrospective cohort study was conducted among adult patients with sepsis admitted to the First Affiliated Hospital of Xinjiang Medical University from January to December in 2020. Gender, age, comorbidities, lactate within 24 hours of admission, albumin, L/A, interleukin-6 (IL-6), procalcitonin (PCT), C-reactive protein (CRP) and 28-day prognosis were recorded. The receiver operator characteristic curve (ROC curve) was drawn to analyze the predictive value of lactate, albumin and L/A for 28-day mortality in patients with sepsis. Subgroup analysis of patients was performed according to the best cut-off value, Kaplan-Meier survival curves were drawn, and the 28-day cumulative survival of patients with sepsis was analyzed.Results:A total of 274 patients with sepsis were included, and 122 patients died at 28 days, with a 28-day mortality of 44.53%. Compared with the survival group, the age, the proportion of pulmonary infection, the proportion of shock, lactate, L/A and IL-6 in the death group were significantly increased, and albumin was significantly decreased [age (years): 65 (51, 79) vs. 57 (48, 73), pulmonary infection: 75.4% vs. 53.3%, shock: 37.7% vs. 15.1%, lactate (mmol/L): 4.76 (2.95, 9.23) vs. 2.21 (1.44, 3.19), L/A: 0.18 (0.10, 0.35) vs. 0.08 (0.05, 0.11), IL-6 (ng/L): 337.00 (97.73, 2 318.50) vs. 55.88 (25.26, 150.65), albumin (g/L): 27.68 (21.02, 33.03) vs. 29.62 (25.25, 34.23), all P < 0.05]. The area under the ROC curve (AUC) and 95% confidence interval (95% CI) of lactate, albumin, and L/A were 0.794 (95% CI was 0.741-0.840), 0.589 (95% CI was 0.528-0.647), 0.807 (95% CI was 0.755-0.852) for predicting 28-day mortality in sepsis patients. The optimal diagnostic cut-off value of lactate was 4.07 mmol/L, the sensitivity was 57.38%, the specificity was 92.76%. The optimal diagnostic cut-off value of albumin was 22.28 g/L, the sensitivity was 31.15%, the specificity was 92.76%. The optimal diagnostic cut-off of L/A was 0.16, the sensitivity was 54.92%, and the specificity was 95.39%. Subgroup analysis showed that the 28-day mortality of sepsis patients in the L/A > 0.16 group was significantly higher than that in the L/A ≤ 0.16 group [90.5% (67/74) vs. 27.5% (55/200), P < 0.001]. The 28-day mortality of sepsis patients in the albumin ≤ 22.28 g/L group was significantly higher than that in the albumin > 22.28 g/L group [77.6% (38/49) vs. 37.3% (84/225), P < 0.001]. The 28-day mortality in the group with lactate > 4.07 mmol/L was significantly higher than that in the group with lactate ≤ 4.07 mmol/L [86.4% (70/81) vs. 26.9% (52/193), P < 0.001]. The three were consistent with the analysis results of Kaplan-Meier survival curve. Conclusion:The early serum lactate, albumin, and L/A were all valuable in predicting the 28-day prognosis of patients with sepsis, and L/A was better than lactate and albumin.

A qualitative study on the expectations of head nurses' core competence in hospital infection prevention and control / 中国实用护理杂志

Objective:To explore the expectations of different groups, including the vice president in charge of hospital infection, hospital infection management professionals, nursing managers, and department directors, on the core competence of head nurses in hospital infection prevention and control.Methods:Using the phenomenological research method, purposive sampling method was used to conduct in-depth semi-structured interviews with 25 interviewees from 5 tertiary general hospitals in Hangzhou City, Zhejiang Province, including vice presidents in charge of hospital infection, hospital infection management professionals, nursing managers, department directors, clinical staff and logistics supervisors. A total of 25 interviewers conducted in-depth semi-structured interviews, and the collected data were analyzed by Colaizzi′s 7-step analysis method.Results:Four themes were extracted, including the expectation of the head nurse′s infection control target management ability, the expectation of the head nurse′s infection control professional knowledge ability, the expectation of the head nurse′s infection control clinical practice ability, and the expectation of the head nurse′s infection control influence.Conclusions:In the sensory control management of the department, head nurses should have strong infection control target management ability, continue to learn and update the infection control knowledge and concepts, improve the clinical infection control practice ability, properly authorize, reasonably motivate and improve the infection control management. Team execution ability, create a good atmosphere of department sense control, and promote the development of infection control work.

Effects of nanosized cadmium sulfide on male reproductive system in mice / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To investigate the effects of nanosized cadmium sulfide (nano-CdS) on the male reproductive system in mice.</p><p><b>METHODS</b>Thirty-six specific pathogen?free male ICR mice were equally and randomly divided into three groups: two experimental groups and a control group. The two experimental groups were exposed to 100 mg/kg and 50 mg/kg nano-CdS once daily by gavage, respectively, while the control group was exposed to the same volume of physiological saline once daily by gavage. After 45 days, levels of cadmium accumulation and serum testosterone in the testis were determined, the epididymal sperm count, the rate of sperm abnormality, and histopathological changes in testis tissue were observed under a microscope, and the level of CYP11A1 mRNA was determined by qRT-PCR.</p><p><b>RESULTS</b>Compared with the control group, the two experimental groups had a significantly increased level of cadmium accumulation in the testis (P < 0.05), and the 100 mg/kg nano-CdS group had a significantly decreased epididymal sperm count (P < 0.05) and a significantly increased rate of sperm abnormality (P < 0.05), but the 50 mg/kg nano-CdS group did not. The 100 mg/kg nano-CdS group showed different histopathological changes in testis tissue, but the 50 mg/kg nano-CdS group did not. The two experimental groups had significantly reduced levels of testosterone and CYP11A1 mRNA compared with the control group.</p><p><b>CONCLUSION</b>Nano-CdS given through the digestive tract may have an effect on the male reproductive system in mice by affecting the key enzyme genes in the androgen synthesis pathway to reduce the levels of reproductive hormones.</p>

Effects of 17?-estradiol on MCF-7 Cell Proliferation and Regulation of Estrogen Receptor-related Receptor (ERR?) / 环境与健康杂志

Objective To understand the effects of 17?-estradiol on MCF-7 cell proliferation and the regulation of estrogen receptor-related recepto(rERR?).Methods MCF-7 cells were treated with 17?-E2 at the doses of 10-12,10-11,10-10,10-9,10-8,10-7 and 10-6 mol/L for 24 h.Dimethyl sulfoxide were used as the solvent control.MTT method was used to determine inhibitory rate of MCF-7 proliferation,and the cells were treated with 17?-E2 at the doses of 10-10,10-9,10-8 and 10-7 mol/L for 24 h.RT-PCR method was used to detect the expression level of ERR?.Results Cell proliferation were promoted by exposure to 17?-E2 at the doses of 10-12,10-11,10-10,10-9,10-8,10-7 and 10-6 mol/L,the proliferation rate were 112.09%,122.09%,123.42%,120.46%,124.60% and 109.23% respectively,however,cell growth was inhibited at 10-6 mol/L of 17?-E2.The expression of ERR? in MCF-7 cells was upregulated at the doses of 10-10,10-9,10-8 and 10-7 mol/L when cells were treated with 17?-E2 for 24 h.Conclusion In certain dosage range,cell proliferation and expression of ERR? can be promoted by 17?-E2,which suggests that ERR? should play an important role in the process of MCF-7 cells growth.