Objective To explore the change of cerebral microcirculation before and after clipping of intracranial aneurysm using CT perfusion (CTP)imaging.Methods CTP images of 70 patients diagnosed intracranial aneurysm by CTA were retrospectively an-alysed.They were divided into four groups according to have or not intracranial arterial spasm:A group:Preoperative CVS,postop-erative CVS (4 cases),B group:Preoperative CVS,postoperative nCVS (13 cases),C group:Preoperative nCVS,postoperative CVS (20 cases),D group:Preoperative nCVS,postoperative nCVS (33 cases).CBV/CBF/MTT were measured in four groups be-fore and after surgery,and analyzed statistically.Results (1)The postoperative CBV/CBF/MTT was compared with the preopera-tive data.There were statistically significant in CBVA/B/C/D/CBFA/B/D/MTTA/B during the surgery (P <0.05 ).There were no statistically significant in the CBFC and MTTC/D during the surgery (P >0.05).(2)There were statistically significant in the△CBVBC/BD/△CBFAB/BC/BD/△MTTAB/BD (P < 0.05 ).△CBVAB/AC/AD/CD/△CBFAC/AD/CD/△MTTAC/AD/BC/CD were no statistically significant (P >0.05).Conclusion CTP can early and accurately predict the change of cerebral microcircu-lation after surgery.

Objective To evaluate the value of contrast-enhanced ultrasound(CEUS) in diagnosis of placental increta.Methods Twenty seven suspected patients with placental increta were examined with CEUS after routine ultrasound examination.SonoVue was injected intravenously as bolus and a real time CEUS was performed.The characteristics of contrast perfusion was analysised.Results Among the three antepartum CEUS cases,two had a clear boundary between the placenta and uterine wall,there was no residual placenta after induced labor;one had a blur boundary between the local placenta and uterine wail,and the local placenta adherenced to the uterine wall tightly when cesarean section was performed after induction failure.Comparison between CEUS and uterine curettage in 20 cases,5 cases had a dear boundary between residual disease in uterine cavity and uterine wall.The boundary between residual disease in uterine cavity and uterine wall disappeared in other 15 cases.Four cases performed total and subtotal hysterectomy,the uterine myometrium of placenta affixing part were very thin (3 - 5 mm),and the boundary between the placenta and uterine wall disappeared,and placental increta was proved by intraoperative and pathology.Conclusions When the boundary between residual placenta and uterine wall disappeared and/or the local uterine wall became thin,placental increta was suggested intensively.

OBJECTIVE:To establish drug use evaluation(DUE)criteria for tigecycline,and to provide reference for rational use of tigecycline. METHODS:Based on tigecycline instructions,referring to related specifications and literatures,DUE criteria for tigecycline was established. And on a basis of it,referring to DUE criteria,in retrospective study,the utilization of tigecycline in 179 inpatients of some one hospital during Nov. 2012-Oct. 2016 was evaluated and analyzed in respects of management indexes, medication indication,medication duration,medication results,etc. RESULTS:The results for DUE of tigecycline in this hospital was that the proportion of patients with consultation records was 83.2%(aiming at 100%);microbial inspection rate was 90.5%(aiming at 80%);the coincidence rate of medication indication was 98.9%(aiming at 90%);the rates of solvent selection,ad-ministration route,drug interaction,incompatibility,drug use in special populations meeting the criteria were all 100%(aiming at 100%);the rate of prescribing authority was 20.1%(aiming at 100%);the rate of drug dosage and medication interval meeting the criteria were 7.3%(aiming at 100%);response rate was 54.7%(aiming at 80%). CONCLUSIONS:Established DUE criteria of tigecycline can standardize the clinical utilization of tigecycline.

Objective To establish a scientific and sensitive evaluation index system of nursing quality for cancer hospital. Methods The evaluation index system of nursing quality for cancer hospital was formulated based on literature,semi- structured interviews and expert group discussion. Then, developing the evaluation index system of nursing quality for cancer hospital by two rounds of Delphi consultation. Results The experts′ authority coefficient was 0.862. The nursing quality indicators included 5 first-level indicators,9 second-level indicators and 73 third-level indicators. The Kendall coordination coefficients of the importance of the three level indicators were 0.354,0.217,and 0.243, The Kendall coordination coefficients of the feasibility of the three level indicators were 0.234,0.313,and 0.339. Conclusions Scientific nature and concentration indicator system of nursing quality for cancer hospital was developed. It will be used to provide quantitative basis for the control of nursing quality in cancer hospital.

Objective To investigate the effects of ulinastatin combined with octreotide in patients with severe acute pancreatitis TAP, SAA and serum inflammatory factors. Methods From February 2011 to September 2016,one hundred and seventy-eight patients with severe acute pancreatitis treated in the Second Affiliated Hospital of Hainan Medical University were enrolled in the study and were divided into the control group(81 cases) and observation group (97 cases). On the basis of routine treatment,the control group was treated with 0. 50 mg octreotide +0. 9% sodium chloride injection,continuous intravenous infusion at 20 mg/h, and 1 time /d,with a total of 3 d. On the basis of the control group,the observation group was given ulinastatin 100 thousand U+250 ml 0. 9% sodium chloride solution intravenous drip,2 times /d,with a total of 3 d. Before and after treatment,TAP,SAA and serum inflammatory factors in two groups were detected and analyzed. Results The levels of TAP,SAA,lipase and amylase in the observation group were (45. 21±9. 64) nmol/L,(458. 62 ±75. 41) mg/L, ( 14731. 7 ± 812. 5) U/L and ( 9341. 3 ± 831. 3) U/L respectively, compared with ( 26. 38 ±7. 13) nmol/L, ( 201. 23 ± 64. 31 ) mg/L, ( 10 321. 4 ± 762. 8) U/L and ( 5 416. 7 ± 306. 8) U/L after treatment. Before treatment,the control group were (43. 14±8. 53) nmol/L,(463. 71±62. 83) mg/L,(13826. 2 ±731.3) U/L and (9126.4±835.1) U/L,and the control group were (37.41±8.32) nmol/L,(316.42 ±68. 71) mg/L,(12 318. 5±797. 3) U/L and (7 423. 1±752. 3) U/L. After treatment,the two groups were lower than those before treatment (P＜0. 05),and the decrease was more obvious in the observation group after treatment. Compared with the control group,the difference was statistically significant ( P＜0. 05) . The level of calcitonin,C reactive protein and triglyceride in the observation group were ( 6. 04 ± 1. 25) ng/mL, ( 237. 3 ±13. 2) mg/L and ( 32. 18 ± 1. 32) mmol/L respectively before treatment. After treatment, they were ( 2. 37 ±0. 96) ng/mL,(48. 9±11. 2) mg/L and (12. 73±3. 61) mmol/L. Before treatment,the control group was (5. 72 ± 1. 43 ) ng/mL, ( 213. 1 ± 16. 2 ) mg/L, ( 30. 76 ± 1. 94 ) mmol/L and ( 5. 32 ± 1. 21 ) mmol/L, respectively. After treatment,they were (4. 21±1. 32) ng/mL,(156. 2±14. 7) mg/L and (24. 69±1. 26) mmol/L respectively. The levels of calcitonin,C reactive protein and triglyceride in the two groups were lower than those before treatment (P＜0. 05),and the decrease was more obvious in the observation group after treatment,and the difference was statistically significant compared with the control group. (P＜0. 05); tn the observation group,the levels of interleukin 6,interleukin 8,TNF - alpha,thromboxane and prostacyclin were (292. 48±19. 57) ng/L, (105. 52 ± 11. 41 ) ng/L, ( 4. 31 ± 0. 58 ) ng/L, ( 442. 16 ± 40. 23 ) ng/L and ( 167. 42 ± 12. 29 ) ng/L respectively.After treatment,they were (67.43±9.21) ng/L,(23.19±3.26) ng/L,(1.27±0.32) ng/L, (192. 20± 16. 89) ng/L and ( 364. 57 ± 27. 02) ng/L respectively. Before treatment, the control group was (278. 31±22. 49) ng/L,(113. 21±11. 45) ng/L,(4. 32±0. 48) ng/L,(428. 32±36. 54) ng/L and (159. 31 ±13. 42) ng/L,compared with (125. 74±16. 52) ng/L,(67. 21±7. 65) ng/L,(3. 16±0. 29) ng/L,(321. 46 ±25. 51) ng/L,(246. 73±20. 52) ng/L after treatment. After treatment,the levels of IL-6,IL-8,TNF-alpha and thromboxane in the two groups were all lower than those before the treatment ( P＜0. 05 ) . The levels of prostacyclin in the two groups were all higher than those before treatment ( P＜0. 05) . Conclusion Ulinastatin combined with octreotide in the treatment of severe acute pancreatitis can reduce the level of blood lipid,reduce inflammatory factors,reduce systemic inflammatory response, improve the patient's inhibition of inflammatory response and promote the balance of inflammatory reaction, and test the patient's TAP, SAA and serum inflammatory response factors to the diagnosis of SAP and the judgment of the disease,and have certain clinical guidance.

Objective:To evaluate the predictive value of mechanical power (MP) on the risk of in-hospital mortality in critical ill patients in emergency department.Methods:A total of 105 critical ill patients with invasive mechanical ventilation in the Department of Emergency of Second Affiliated Hospital of Guangzhou Medical University between December 1, 2017 and October 31, 2020 were retrospectively analyzed. Based on the clinical prognosis, the patients were divided into the in-hospital survival group (80 patients) and the in-hospital death group (25 patients). The clinical data and ventilator parameters were recorded, and the MP of the two groups was calculated in order to assess the predictive efficacy of MP on in-hospital death.Results:Compared to the in-hospital death group, the oxygenation index PaO 2/FiO 2 was significantly higher (271 mmHg vs. 217 mmHg, P=0.020) and blood lactate (1.59 mmol/L vs. 2.56 mmol/L, P<0.001) and procalcitonin (0.31 ng/mL vs. 3.55 ng/mL, P=0.028), minute ventilation (7.03 L/min vs.8.32 mmol/L, P=0.013), MP (14.37 J/min vs. 16.12 J/min, P=0.041), SOFA score (5 vs. 8, P=0.001) and APACHE II score (16 vs. 22, P=0.041) were significantly lower in the in-hospital survival group. Multivariate Logistic regression analysis showed that PaO 2/FiO 2( OR=1.015, P=0.044), MP ( OR=1.813, P=0.039) and SOFA score( OR=2.651, P=0.010) were independent risk factors for predicting hospital mortality in patients with mechanical ventilation. The areas under the ROC curves (AUC) were 0.62, 0.63 and 0.75, respectively. Moreover, the MP combined with SOFA score for predicting in-hospital death was significantly higher than that of MP alone (0.77 vs. 0.63, P<0.05). Conclusions:MP is associated with in-hospital death in patients with invasive mechanical ventilation in emergency department. MP combined with SOFA score can enhance its predictive efficacy

Objective To investigate the prevalence of iron deficiency(ID)and iron deficiency anemia (IDA) in pregnant women in urban areas of China. Methods The study was a national cross-sectional survey conducted from September 19th, 2016 to November 20th, 2016. According to the classification of the National Bureau of Statistics, all survey sites were set up in 6 regions of the country. Pregnant women were continuously selected using multistage stratified sampling. A total of 12 403 pregnant women were collected and examined for serum ferritin and hemoglobin levels. Results The median serum ferritin level during pregnancy was 20.60 μg/L(11.78-36.98 μg/L), the hemoglobin level was(118±12)g/L. With the progress of pregnancy, the levels of serum ferritin and hemoglobin decreased gradually. The median serum ferritin levels in the first, second trimester and third trimester were 54.30 μg/L(34.48-94.01 μg/L), 28.60 μg/L(16.40-50.52 μg/L), and 16.70 μg/L(10.20-27.00 μg/L)respectively(P<0.01). The mean hemoglobin levels were(127 ± 10)g/L,(119 ± 11)g/L and(117 ± 11)g/L respectively(P<0.01). The prevalence of ID in urban pregnant women was 48.16%(5 973/12 403), and IDA prevalence was 13.87% (1 720/12 403). The prevalence of IDA in the first, second trimester and third trimester were 1.96% (20/1 019), 8.40%(293/3 487)and 17.82%(1 407/7 897), respectively(P<0.01). The prevalence of standardized ID and IDA were significantly different in various regions of China(P<0.01). The standardized prevalence of ID were relatively higher in East China and Northeast China, 57.37% and 53.41% respectively, while it was the lowest in Southwest China, 30.51%. The standardized prevalence of IDA in South Central, Northwest, and East China were relatively high, 21.30%, 16.97% and 17.53% respectively, and the standardized prevalence of IDA in Southwest China was the lowest, 5.44%,the differents in various regions were significant(all P<0.01). Conclusion The current phenomenon of ID and IDA in pregnant women is still very common,and nutrition and health care during pregnancy should be strengthened.

Objective To investigate high risk human papillomavirus(HR-HPV)prevalence among married women in Beijing and to study the high risk flactors.nethods During March 2007 to September 2008.a total of 6185 married women sampled from 137 communities in 12 districts were screened bv HR-HPV DNA test and cytogical test.The interview was carried out with unified questionnaires.The databage was set up and twice entered in EpiDam 3.0.After checked up,the data were analyzed in SPSS 15.0.Results (1) The HR-HPV infection rate was 9.89%.The HR-HPV infection rate of the city zone,the suburb and the exurb were 9.34%,10.51% and 9.51% (P>0.05).The HR-HPV infection rate of the native and the oudander were 9.53%,11.30% (P<0.05).(2) The age distribution of HR-HPV infection was that the rate was around 10% among 25 to 44 age groups,which was the highest(11.21%) in 30 to 34 age group;then the rate was descended as the age raising,the rate of 50 to 54 age group was the lowest(7.78%).(3) Multiple logistic regression showed that the related risk factors of HR-HPV infection mainly included 1000 RMB and above of family income per person per month.possessing more than 1 sexual partner of her husband,outlander and hish levels of education.(4) The prevalence of cervical intraepithelial neoplasia(CIN)in HR-HPV positive group wag significantly higher than that in HR-HPV negative group(29.76% vs 3.32%,P<0.01).Conclusions(1)The HR-HPV infection rate among aged 25 to 54 years was 9.9% and there was no significant difference in area distribution.(2)The hish risk population which should strengthen screening was the married bearing-age women with high level of family income,outlander,high levels of education and her husband possessing more than 1 sexual partner.(3)HR-HPV infection is the main risk factor for CIN and cervical cancer.while does not provide a causal relationship with them.The high risk population should be checked regularly to understand the development of HR-HPV infection and CIN incidence.