Objective To explore the effect of controlled premature delivery and its termination method of pregnancy.Methods The clinical data of 151 cascs of controlled premature delivery were retrospectively analyzed.Results The incidence of premature delivery was 7.5% and the incidence of controlled premature delivery was 44.8%.The cesaran section rate of controlled premature delivery Was 93.4%.Pregnancy induced hypertension(PIH)was the first place reason of controlled premature delivery.The second was antepartum hemorrhage,intrauterine fatal diatress and placenta previa,pregnancy associated with cardiac disease.The complications and mortality of premature infants were reduced if antenatal care is regularly and glucocorticoids could be used.Conclusion Antenatal care and proper treatment can increase the survival rate of premature infants in the inevitable controlled delivery.

Objective To constructthe nurse job satisfaction index evaluation system by analytic hierarchy process (AHP) so as to provide theoretical basis for nursing managers. Methods Semi-structured interviews and literature review were used in establishing the preliminary nurse job satisfaction evaluation index system.The Delphi method was applied in expert consultation and a three-level index system was established, the weight, the largest eigenvalue and the weight vector were all calculated. Index consistency was inspected. Results 4 first-level indicators, 13 second-level indicators and 39 third-level indicators were established.The weight was 1.630 0-3.280 0 for the first-level indicators, 0.4494-1.4723 for the second-level indicators and 0.0913-0.783 9 for the third-level indicators.The weight vector was 0.038-0.616 for the first-level indicators,0.045-0.750 for the second-level indicators and 0.041-0.875 for the third-level indicators.The max-eigenvalue was 4.231 for the first-level indicators,6.226 for the second-level indicators and 4.176 for the third-level indicators. The consistency test value of judgment matrix ranged from 0.000 to 0.077, and the consistency ratio was less than 0.1. Conclusions With distinct gradation,clear structure, reasonable weight and rich content, the index system provides a theoretical basis for the nurse job satisfaction evaluation.

Objective To evaluate the specificity,sensitivity and clinical significances of direct antiglobulin test of bone marrow monouclear cells (BMMNC-Coombs test) and Flow Cytometry (FACS).Methods Autoantibodies on bone marrow mononuclear cells of 270 patients with immune and 471cases with primary or secondary anaemia and 19 normal controls were measured by BMMNC-Coombs test,and a part of IRP patients with negative BMMNC-Coombs test were retested by FACS.Results In 270 immune hemocytopenia patients,there were 163 (60.37%) with positive BMMNC -Coombs test.The positive rate of patients with immunorelated pancytopenia (IRP) was upmost and accounted for 67.2%.AIHA 63.6%,ITP 57.1%,Evans syndrome 43.2%.Both 471 patients with primary or secondary anaemia and 19 normal persons were all negative.In BMMNC-Coombs positive cases,there were mainly three types including IgG,IgG+C_3,IgG+IgM+IgA+C_3,they accounted for 30.4%,26.4%,20.8%.61 1RP with negative BMMNC-Coombs test were teased again for their BMMNC autoantibodies by FACS.83.6% of them were found to be positive with autoantibodies on BMMNC.The positive rate of autoantibodies on hematopoietic stem cells of IRP patients was 94.1%.it was higher than positive rate on any other types of bone marrow hematopoietic cells.Conclusion the sensitivity and specificity of BMMNC-Coombs test for diagnosis of autoimmune hemocytopenia was high,but the sensi- tivity of FACS assay was higher than that of BMMNC-Coombs test for detecting autoantibodies.Also had IRP,AIHA, ITP and Evans syndrome patients autoantibodies on bone marrow hematopoietic cells,The difference between IRP and other immune hemocytopenias was that IRP patients did have autoantibodies only on BMMNC.

Objective To evaluate effect of intensive insulin treatment(IIT)on healthcare-associated infection (HAI)rate in patients with acute stroke and stress hyperglycemia.Methods Databases,including PubMed,Em-base,Cochrane Library,WanFang,and China National Knowledge Infrastructure(CNKI)Data,were electronically searched,relevant journals and references of the included literatures were also searched manually,literatures were selected according to the uniform inclusion and exclusion criteria,incidence of HAI and mean blood glucose in patients who received IIT for acute stroke were assessed systematically.Results A total of 13 randomized controlled trials (RCT)involving 1 032 patients were included in this systematic review.Meta-analysis results showed that 10 studies involving 832 patients were finally enrolled for comparing HAI rate, HAI rates in IIT group and conventional insulin treatment group were 28.3% and 56.1 %,respectively(Z =4.50 ),difference between two groups was statistically significant (RR=0.53 [95 %CI :0.40 to 0.70],P <0.001 );A total of 328 patients in 5 studies were finally included in the comparison of blood glucose,difference in mean blood glucose between two groups was statistically significant(MD =-2.52 [95% CI :-4.30 to -0.74],P =0.006).Funnel plot of HAI rate revealed that there was publication bias.Conclusion IIT is used for the regulation of stress hyperglycemia in acute stroke,it can reduce the incidence of HAI and blood glucose in patients.

Objective To assess the psychometric properties of the Chinese Heartburn Version of Quality of Life in Reflux and Dyspepsia Questionnaire (QOLRAD) in patients with gastroesophageal reflux disease.Methods 130 patients with symptoms of heartburn completed the Chinese version of QOLRAD,the Short-Form-36 (SF-36).30 of them received proton pump inhibitors (PPI) for 8 weeks,which was used to test responsiveness of the Chinese heartburn version of QOLRAD.Results The Chinese version of QOLRAD had acceptable internal consistency.The overall Cronbach's alpha was 0.89 and the internal consistency of dimensions ranged from 0.70～0.90.Content validity index (CVI) was 0.82.Confirmation factor analysis revealed a 5 factor solutions accounting for 62.02％ and most of items in their dimensions had acceptable loads (＞0.4).There was acceptable concurrent validity with correlations between the Chinese heartburn version of QOLRAD and Short Form-36 health survey ranging from 0.172～0.613.As to responsiveness,after therapy of PPI for 8 weeks,except the dimension of sleep disturbance,scores for dimensions of vitality,food/drink problems,physical/social functioning,emotional distress had significant changes.Conclusions The Chinese version of QOLRAD has a good reliability,validity and responsiveness to therapy,which can be used to assess the quality of life in patients with gastroesophageal reflux disease.

Objective To discuss the expression of X chromosome coupled zinc finger protein(ZFX) in the serum and pathology of patients with advanced non-small cell lung cancer before and after treatment and its evaluation in the chemotherapy efficacy.Methods Forty cases(NSCLC group)with non-small cell lung cancer treated in Baotou Central Hospital from January 2013 to October 2014 were retrospectively analyzed.The control group included 40 normal people who may have tumor by normal physical examination.Based on the blood tests of research subjects before and after treatment,the peripheral blood ZFX content was detected by the quantitative detection, ZFX expression was detected by tissue morphological identification and immunohistochemical methods.Results The level of adenocarcinoma ZFX serum was(15.32± 2.01)μg/L, squamous cell carcinomas ZFX serum level was(11.65±4.12)μg/L,the difference between the two groups was statistically significant(t=3.216,P<0.05); the ZFX serum level of non-small cell lung cancer group was (17.55±0.37)μg/L before treatment,and was(6.35± 0.06)μg/L after treatment which was significantly lower,the difference was statistically significant(t=188.97,P<0.05); the serum level of non-small cell lung cancer group before treatment was(17.55±0.37)μg/L,after treatment was(6.35±0.06)μg/L,compared with (2.29± 0.01)μg/L,(2.29 ± 0.01)μg/L in the control group,the differences were statistically significant (before treatment:t=260.75,after treatment t=422.14,P<0.05); the expression of ZFX in adenocarcinoma was(15.32±2.01)ug / L,higher than that of squamous cell carcinoma((11.65±4.12)μg/L),the difference was statistically significant(t=3.216,P<0.05);the expression of ZFX in CR+PR group before treatment was (17.35±0.46)μg/L,higher than that after treatment((6.24±0.11)μg/L),the difference was statistically significant(t=142.88,P<0.05).Conclusion The expression of ZFX in peripheral blood serum and pathology may be a marker for the diagnosis of non-small cell lung cancer,and it has guiding significance for the diagnosis and curative effect evaluation of lung cancer.

Objective To explore efficacy and safety of simulated artificial pancreas in modulating stress hyperglycemia in critically ill patients. Methods A prospective randomized controlled study was performed. Seventy-two critically ill patients with stress hyperglycemia, aged 18-85 years, acute physiology and chronic health evaluationⅡ(APACHEⅡ) score over 15, two consecutive random blood glucose 11.1 mmol/L or higher, glycated hemoglobin (HbA1C) below 0.065, unable to eat food for 3 days after inclusion, or only accepting parenteral nutrition, admitted to intensive care unit (ICU) in Shanghai Punan Hospital of Pudong New District from January 1st, 2015 to June 30th, 2017 were enrolled. The patients were divided into three groups according to the random number table method, high-intensity group and low-intensity group were injected Novolin R (high-intensity group 2/3 dosage, low-intensity group 1/3 dosage) to modulate stress hyperglycemia by simulated artificial pancreas. Simulated artificial pancreas consisted of Guardian real time glucose monitoring system (GRT system), close-circle control algorithm and micro-pump;subcutaneous injection of Humulin 70/30 was applied to modulate stress hyperglycemia in humulin group. Real-time glucose levels of interstitial fluid in abdominal wall, equivalent to blood glucose levels, 10 minutes each time, were monitored by using of GRT system for all patients in three groups. Fasting serum levels of stress hormones including epinephrine and cortisol and insulin resistance index (IRI) were recorded within 24 hours after inclusion. Mean blood glucose, blood glucose variation coefficient, blood glucose target-reaching rate, blood glucose target-reaching time, hypoglycemia rate and 6-month mortality were measured. Twenty healthy adults from health administration department of the hospital were recruited as healthy control group. Results A total of 60 eligible critically ill patients were included in this study, each group with 20 patients. There was no significant difference in gender, age, APACHE Ⅱ scores among three groups. The levels of serum epinephrine, cortisol and IRI within 24 hours after inclusion in the three groups were significantly higher than those in healthy control group. The mean blood glucose levels of humulin group, low-intensity group, high-intensity group were decreased (mmol/L: 10.2±3.2, 8.4±2.6, 8.1±2.2), the blood glucose target-reaching rate were increased [40.2% (3 295/8 196), 71.1% (5 393/7 585), 80.4% (6 286/7 818)], the blood glucose target-reaching time were shortened (hours: 49.1±5.8, 24.6±4.6, 17.5±4.2), the hypoglycemia rates were increased respectively [1.3% (108/8 196), 2.8% (211/7 585), 4.0% (313/7 818)], with statistically significant differences (all 1 = 0.000). There was no significant difference in blood glucose variation coefficient and 6-month mortality among three groups [blood glucose variation coefficient: (29.4±3.7)%, (28.5±5.3)%, (26.1±4.6)%, 6-month mortality: 55.0%, 45.0%, 40.0%, all 1 > 0.05]. Conclusions Simulated artificial pancreas could effectively and safely modulate stress hyperglycemia in critically ill patients, high-intensity modulation could bring about better efficacy in the regulation of hyperglycemia. High-frequency blood glucose monitoring by using GRT system could promptly identify hypoglycemia and help it to be corrected.

OBJECTIVETo compare the prognostic value of different models in patients with early-stage diffuse large B-cell lymphoma (DLBCL).

METHODSEarly-stage DLBCL patients diagnosed from January 2000 to December 2012 were analyzed retrospectively. All patients received with at least 2 cycles of immunochemotherapy R-CHOP regimen (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) with or without radiotherapy. The prognostic value of international prognostic index (IPI) , revised IPI (R-IPI) and enhanced IPI (NCCN-IPI) was compared.

RESULTSNinety-seven cases of early-stage DLBCL were included in the study. The median age was 58 years (15-88 years) with a median follow-up of 34.7 months (range 7.3-77.4 months). The expected 5-year overall survival (OS) for entire group was 82%. There was no patient in the high risk group according to IPI or NCCN-IPI. According to IPI, the 5-year OS in the low, low intermediate, high intermediate risk groups were 95%, 38% and 60%, respectively. According to R-IPI, the 5-year OS in the very good, good, and poor risk groups were 93%, 75% and 60%, respectively. According to NCCN-IPI, the 5-year OS in the low, low intermediate, high intermediate risk groups were 92%, 85% and 29%, respectively.

CONCLUSIONNCCN-IPI would be of an ideal prognostic model for early-stage DLBCL patients.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antibodies, Monoclonal, Murine-Derived ; Antineoplastic Combined Chemotherapy Protocols ; Cyclophosphamide ; Doxorubicin ; Humans ; Immunotherapy ; Lymphoma, Large B-Cell, Diffuse ; diagnosis ; Middle Aged ; Prednisone ; Prognosis ; Retrospective Studies ; Rituximab ; Vincristine ; Young Adult

Objective:To evaluate the test-retest reliability of MRI criteria in the 2019 Bosniak classification of cystic renal masses (CRMs) and to analyze the impact of lesions′ property, size and readers′ experience on the test-retest reliability.Methods:From January 2009 to June 2019, 207 patients with 207 CRMs were included in this retrospective study. All of them underwent renal MRI and surgical-pathologic examination. According to Bosniak classification, version 2019, all CRMs were independently classified twice by eight radiologists with different levels of experience. All radiologists were blinded to the pathology of the lesions. By using intraclass correlation coefficient (ICC), test-retest reliability was evaluated for all CRMs and for subgroups with different pathological properties (benign and malignant) and different sizes (≤40 mm and>40 mm). The test-retest reliability of 4 senior readers (≥10 years of experience) and 4 junior readers (<10 years of experience) were evaluated respectively. The comparison of ICC was performed using Z test. Results:The 207 CRMs included 111 benign lesions (83 benign cysts, 28 benign tumors) and 96 malignant tumors. There were 87 lesions with maximum diameter ≤40 mm and 120 with maximum diameter>40 mm. The test-retest reliability (ICC) of each reader for all lesions was 0.776-0.888, the overall ICC was 0.848 (95%CI 0.821-0.872). The ICCs of senior and junior readers were 0.853 (95%CI 0.824-0.880) and 0.843 (95%CI 0.811-0.871) respectively, without significant difference between the two groups ( Z=0.85, P=0.374). The ICC of all readers was 0.827 for benign lesions and 0.654 for malignant lesions, showing significant difference ( Z=2.80, P=0.005). The ICC was 0.770 for lesions ≤40 mm and 0.876 for lesions>40 mm, which was significantly different ( Z=-2.36, P=0.018). For CRM subgroups with different pathological properties and different sizes, there was no significant difference in test-retest reliability between senior and junior readers (all P>0.05). Conclusion:The test-retest reliability of MRI criteria in the 2019 Bosniak classification of CRMs is excellent and unaffected by readers′ experience. The reliabilities are not consistent among CRMs of different pathological properties and different sizes, but all reached the level of good and above.