Objective To determine whether anticoagulation markers can improve mortality prediction in patients of surgical intensive care unit (ICU).Methods A case-control study was adopted,252 patients from Tongji hospital's surgical ICU and 30 healthy control individuals were investigated.The protein C,antithrombin,thrombomodulin,and other coagulation/ inflammatory markers were detected.The Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score were obtained.Markers level comparison among survivors,non-survivors and controls were conducted with single factor variance analysis,Kruskal-Wallis test or Mann-Whitney U test.Results Between survivors and non-survivors after 28-day hospitalization,there were significant difference on protein C levels[(70.2 ±22.7)％ vs (48.6 ±29.8)％,t=2.84,P＜0.01],APACHE Ⅱ scores[(21.0±8.2) vs (29.5 ±10.9),t =-2.51,P＜0.05] and prothrombin times[(12.9-± 3.5) s vs (18.8 ± 10.2) s,t =-2.13,P ＜ 0.05].Combining protein C levels with APACHE Ⅱ score could obtain a higher mortality prediction efficiency in patients of surgical ICU than any single marker (AUC =0.806).That protein C concentration less than 47.5％ [OR =6.40,95％confidence interval(CI) 2.526-16.216,P ＜0.001] and APACHE Ⅱ score (OR =1.123,95％ CI 1.012 -1.250,P ＜ 0.05) were the independent risk factors for surgical ICU death.Conclusion Decrease of protein C levels predict increase of mortality risk in patients of surgical ICU,combining protein C with APACHE Ⅱ score can improve the prognostic accuracy for patients of surgical ICU.(Chin J Lab Med,2013,36:339-342)

Objective To investigate the change of soluble P-selectin (sPsel)and von Willebrand factor (vWF)levels after ad-mission in traumatic patients and their relation with the coagulation indexes levels,coagulation disorders and prognosis.Methods 82 cases of severe trauma in ICU of Affiliated Tongji Hospital were prospectively selected and detected plasma sPsel,VWF anti-gen,protein C,activity of coagulation factor Ⅶ and routine coagulation indexes on admission and on every day within the first week after admission.The 30 d fatality rate was recorded.Results The sPsel and vWF levels on admission in the patients with coagula-tion disorders were lower than those in the patients without coagulation disorders (P <0.05)and significantly correlated with the coagulation indexes (protein C and coagulation factor Ⅶ)levels (P <0.05).The vWF level within 3 d after admission in the death patients was significantly lower than that in the survival patients,but which on 7 d after admission in the death patients was signifi-cantly higher than that in the survival patients (P <0.05 );no significant difference in sPsel level within 1 week after admission were found between the survival patients and the death patients.Conclusion Among severe traumatic patients in ICU,the low lev-els of sPsel and VWF on admission are associated with the coagulation disorders,the significant rise of vWF level on 7 d after ad-mission is associated with the increase of the 30 d fatality rate.

Abstract：Objective To evaluate the basic development status of public health emergencies of infectious diseases in Hainan Province from 2013 to 2022, analyze the distribution and characteristics of these emergencies, as to provide important scientific basis for the study and formulation of economic health development planning policies, for the health security policies and infectious disease prevention and control strategies in Hainan Province. Methods The relevant statistical data of public health emergencies involving infectious diseases reported in Hainan Province from 2013 to 2022 were collected, and the status quo of these emergencies was analyzed by using descriptive data statistical analysis method. The ARIMA model was used to predict the number of public health emergencies reported by infectious diseases in Hainan Province from 2023 to 2025. Results From 2013 to 2022, a total of 482 public health emergencies were reported in Hainan Province, of which 426 were infectious disease public health emergencies, accounting for 88.38%, with a total of 8 876 cases, an incidence rate of 0.61%, and eight deaths, a case fatality rate of 0.09%. The major public health emergencies of infectious diseases were unclassified events and general events, accounting for 69.25% and 29.58%, respectively. The main diseases were novel coronavirus infection, chickenpox and hand, foot and mouth disease, accounting for 45.07%, 15.49% and 11.97%, respectively; in terms of time distribution, the number of reported incidents showed an upward trend over time, with a decline in 2021, and mainly had three peak periods, April, August and December, with a total of 220 cases reported; in terms of regional distribution, the major cities and counties reported were Haikou, Wanning and Wenchang, accounting for 27.46%, 19.25% and 9.86%, respectively; in terms of location distribution, the events mainly occurred in schools, accounting for 42.02% of the total number of incidents. The ARIMA(1, 1, 0) model was used to predict infectious disease public health emergencies, and the results showed that the forecast state would be stable from 2023 to 2025, with no obvious upward trend, that is, the fluctuation range of public health emergencies related to infectious diseases in Hainan Province would be stable in the next three years. Conclusion The number of infectious disease public health emergencies reported in Hainan Province from 2013 to 2022 has increased year by year, with a decline in 2021. Although the forecast shows that public health emergencies such as infectious diseases are relatively stable with no obvious upward trend, the prevention and control of the epidemic should not be taken lightly. Hainan Province should continue to increase the investment in monitoring public health emergencies, improve the information system of public disease prevention and control, and carry out real-time monitoring of public health emergencies of infectious diseases.

Sufficient and organized sleep is a key factor during the developmental process of infancy while disrupted sleep schedule and diseases might lead to sleeping disorders in infants. Breastfeeding is considered to be the most beneficial way to meet the nutritional needs of infants for optimal growth and development. The α-lactalbumin-tryptophan-melatonin axis, nucleotides, and other factors are breast milk components that may affect infant sleep. Meanwhile, diet, feeding schedule, tobacco smoking, alcohol intake, and caffeine consumption will affect the circadian rhythms which might lead to the fluctuations of sleep-influencing factors in breast milk. This study reviews literature of previous studies on this topic to summarize information that can be considered for both breastfeeding practice and future basic research on the establishment of organized sleep patterns in infants.