Objective To evaluate the early diagnosis value of blood neutrophil gelatinase-associated lipocalin (NGAL) and interleukin-18 (IL-18) in patients with sepsis-induced acute kidney injury (AKI). Methods A prospective case controlled study was conducted. Fifty-six patients with sepsis but without renal disease admitted to intensive care unit (ICU) of Shanxi People's Hospital from April 2014 to April 2015 were enrolled. Blood lactic acid and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score at ICU admission were recorded. The urine output, blood urea nitrogen (BUN), serum creatinine (SCr), NGAL, IL-18 and tumor necrosis factor-α (TNF-α) were continuously monitored for 48 hours. The patients were divided into AKI group and non-AKI group according to the diagnostic criteria of Kidney Disease: Improving Global Outcomes (KDIGO). The changes trend in above parameters between the two groups at different time points were compared. The early diagnostic value of NGAL, IL-18, and SCr for sepsis-induced AKI was evaluated by receiver operating characteristic curve (ROC). Results Compared with non-AKI group, with the time prolongation after ICU admission, the traditional parameters reflecting AKI urine output in sepsis-induced AKI group was decreased gradually, BUN and SCr were gradually increased, and a statistically significant difference was found at 12 hours between the two groups [BUN (mmol/L): 11.8±3.5 vs. 8.2±3.5, SCr (μmol/L): 88.6±11.3 vs. 74.0±11.0, both P < 0.01]; but the new indicators NGAL and IL-18 reflecting AKI had a statistically significant difference at 6 hours [NGAL (μg/L): 426.7±90.7 vs. 382.3±67.9, IL-18 (ng/L): 75.7±9.3 vs. 70.9±7.3, both P < 0.05]. It was shown that in AKI group, NGAL and IL-18 compared with BUN and SCr increased at least 6 hours ahead of schedule. The area under ROC curve (AUC) of 6-hour NGAL and IL-18 in patients with sepsis-induced AKI were 0.821 [95% confidence interval (95%CI) = 0.713-0.931] and 0.719 (95%CI = 0.584-0.853) respectively, superior to SCr (AUC = 0.677, 95%CI = 0.528-0.825). The cutoff value of NGAL was 363.58 μg/L, and the sensitivity and specificity were 88.0% and 86.7% respectively. Conclusions NGAL and IL-18 in the early prediction of sepsis patients with AKI are better than SCr, and NGAL was most sensitive. Therefore, NGAL can be used as an early biomarker for the diagnosis of AKI in patients with sepsis.

Objective To understand the application status of physical assessment in clinical nurses. Methods Using self-designed physical assessment skills questionnaire to investigate nurses in six provinces of China, 1115 questionnaires were valid. Results There were 171 items in this questionnaire,4.0% of them were used regularly, 19.3% used frequently, 76.7% used occasionally. The result of Spearman correlation showed that there was positive correlation between the frequency of physical assessment skills and the subjective needs of nurses, regional, educational background, hospital level. There was also negative correlation with title, age and seniority. Conclusions The main factors lead to imbalance development of physical assessment skills are regional, hospital-level and education background; the assessment skills of specialist hospitals and wards need to be standardized immediately.

Objective To understand the subjective perception and influential factors of physical assessment technique in clinical nurses. Methods Using self-designed physical assessment skills questionnaire to investigate nurses in the six provinces of China, 1115 questionnaires were valid. Results There were 11 items in this questionnaire. The first four were: physical assessment is an essential skill of nurses (88.1%),the importance of continuous learning (84.8%), lack of maturity assessment tools (79.8%), heavy workload,lack of time (60.8%). The result of multiple regression analysis (stepwise) showed that hospital-level and regional were the main factors affecting the subjective perception. Conclusions The development of physical assessment reies mainly on rational allocation of human resources structure, establishing the physical assessment framework, and make sure different departments have their own characteristics and the importance of continuing education.

Objective To explore the clinical effect of mifepristone combined with misoprostol for termina-tion of pregnancy in high risk pregnant women and provide reference for clinical treatment.Methods 182 cases of high -risk maternal were divided into observation group and control group by the random number table method,each group 91 cases.The control group was treated with conventional abortion termination of pregnancy,the observation group was treated with the artificial abortion before oral administration of mifepristone tablets and misoprostol tablets. The operation time,the amount of blood loss,the degree of pain,the degree of cervical softening and the occurrence of complications of induced abortion were compared between the two groups.Results The operation time of the observa-tion group was (2.21 ±1.41)min,intraoperative bleeding was (15.29 ±4.06)mL,which were significantly less than those of the control group (t =7.122,8.256,all P <0.05);The pain degree grade I in the observation group was 58.24%,which was significantly higher than that in the control group,grade III accounted for 5.49%,which was sig-nificantly lower than the that in the control group (χ2 =44.887,44.121,all P <0.05),the observation group of cer-vical softening full was 59 cases,full softening rate was 64.84% and the control group in the cervical softening full was 41 cases,softening full rate was 45.05%.Fully softening rate in the observation group was significantly higher than that in the control group (χ2 =7.191,8.411,P <0.05),the control group,the incidence of uterine perforation in 2 cases,the occurrence of artificial abortion syndrome 7 cases,the incidence of complications for 9.89%,the obser-vation group had no uterine perforation occurred,1 case of artificial abortion syndrome and complications occurred rate was 1.10%.The incidence of complications in the observation group was significantly lower than that in the control group (χ2 =6.772,P <0.05).Conclusion Mifepristone combined with misoprostol for high -risk maternal termi-nation of pregnancy could significantly shorten the artificial abortion operation time,reduce intraoperative blood loss, reduce the patient pain,reduce the incidence of complications.

Anoctamin 1 (ANO1) is a calcium-activated chloride channel and is amplified and over-expressed in gastrointestinal stromal tumor, breast cancer, bladder cancer, head and neck squamous cell cancer, esophageal squa-mous cell cancer, prostate cancer and pancreatic cancer.The amplification and over-expression of ANO1 are associated with lymph node metastasis and poor prognosis.ANO1 promotes tumor formation and metastasis, and the drugs that inhibit the activity or expression of ANO1 show antitumor effects.Therefore, ANO1 may promote the tumorigenesis, and may be a molecular biomarker and a new target for cancer therapy.

Logistics supplies are essential for normal operations of hospitals,while effective management of hospital suppliers is key to optimizing the materials supplies.An evaluation system is built for both key suppliers and standby suppliers respectively.Based on such a system,a dynamic management mechanism is built to provide long-lasting supplier incentives,for competitive selection and elimination of the suppliers.These efforts enable the hospitals to pick the best suppliers by means of systems and regulations.

Objective · To investigate the intention of quitting smoking and influencing factors among husbands in gestational households in Shanghai and provide a scientific basis for establishing smoking cessation strategies. Methods · Pregnant women and their spouses who received antenatal examination in 5 hospitals in Shanghai were asked to finish two versions of questionnaires respectively. Basic demographic information, smoking history, history of smoking cessation and intention of quitting smoking were investigated. The database was set up by EpiData 3.1, and data were analyzed by SPSS 22.0, such as descriptive analysis, χ2 test (univariate), and Logistic regression analysis (multivariate). Results · A total of 282 questionnaires were sent to smoking husbands and 266 effective questionnaires got back with the effective rate of 94.3%. Among them 34.2% smoking husbands had intention of quitting smoking, 18.4% were trying to quit, and 22.9% had tried to quit before. Single-factor analysis showed that influencing factors for intention of quitting smoking among smoking husbands in gestational households included the daily cigarette consumption, overall opinion for smoking, the knowledge about the harm of passive smoking to pregnant women and fetuses, having smoking cessation experience or not, how many people smoking among five intimate friends except family members (P<0.05). Multivariate Logistic regression analysis showed that intention of quitting smoking had relationship with the daily cigarette consumption (OR = 0.456, 95% CI: 0.245 ~ 0.852), overall opinion for smoking(OR=2.443, 95% CI: 1.008 ~ 5.921), having smoking cessation experience or not (OR =0.316, 95% CI: 0.162 ~ 0.616). Conclusion · Intention of quitting smoking is relatively strong in gestational households. It is recommended to strengthen the education of tobacco control for smoking husband in gestational households, and encourage smokers who had smoking cessation experience before to quit smoking again.

Angiogenesis plays a very important role in the development and metastasis of breast cancer. Low-dose metronomic chemotherapy based on the traditional chemotherapy drugs has antiangiogenic effect. As far as its mechanism, low toxicity or low incidence of drug resistance is concerned, it is feasible for breast cancer therapy. It displayed the validity and feasibility in the pre-clinical studies and clinical trials, which provided a new treatment strategy for the breast cancer.

Objective: To evaluate the application of two-dimension and color Doppler ultrasound in diagnosis and differential diagnosis of fascial space infection in maxillofacial region. Methods: Retrospective analysis was conducted on 87 cases of maxillofacial space infections, among which there were 6 suspected cases of accompanying tumor.Results: In the 87 cases, 53 had abscess formation, confirmed by operative drainage or puncture biopsy. The pathological studies revealed 2 cases of Non-Hodgkin's lymphoma, and 1 case of branchial cleft cyst accompanied with infection. The 3 cases showed characteristic appearance in ultrasonic imaging. The space infection presented stronger echogenicity than that in tumors. In this study, 95% (83/87) cases showed grey or medium echogenic dots, while 4.5% (4/87) cases did not show obvious echogenic dots due to a large amount of abscess, and 2 cases of tumors, however, did not show any echogenic dots. In addition, 87% (76/87) cases had few blood flow in the lesion areas, and 22% (2/87) cases had much blood flow in the lesion areas. All cases showed that the lesion areas and the blood flow reduced obviously with enhanced echo following anti-inflammatory treatment except 2 cases accompanied with tumor without obvious changes in lesion areas and blood flow.Conclusion: The ultrasonic diagnosis with two dimension and color Doppler ultrasound has high accuracy in diagnosis of maxillofacial space infection, with accordance rate up to 96.6%, much higer than CT/MRI. It is suggested that the two dimension and color Doppler ultrasound can be used as a prior choice of diagnosis.

Objective To do a hygienic assessment for the preservation time of barreled drinking water. Methods 40 kinds of barreled drinking water samples, all passed the water quality test, were collected from the market in summer and autumn respectively. Each sample was put into a sterile bottle and then taken into the laboratory in 2 hours to detect the microorganism indicators in 0 day, 5 days, 10 days, 15 days and 20 days periodically. Results The qualified rate of microorganism indexes reached 100% in 10 days. As for total bacteria count, 97.5% exceeded the hygiene standard limit,the detected rate of fungi and yeast were 17.5% and 12.5% in 15 days, and 100% exceeded the standard limit,the detected rate of fungi and yeast were 30.0% and 22.5% in 20 days in summer. The qualified rate of microorganism indexes reached 100% in 20 days in autumn. Conclusion Barreled drinking water is safe for drinking in 10 days in summer and in 20 days in autumn.