Objective To develop a scientific and objective risk factors evaluation index system for peri-operative hypothermia. Methods Based on literature review, the risk factors evaluation index system for peri-operative hypothermia was screened and identified by Delphi method,and the weight was identified through Hierarchy analysis. Results In two rounds of surveys, the rates of questionnaire retrieval were 94.4% and 100.0%, respectively. The authoritative coefficients were 0.83 and 0.84, the coordination coefficients were 0.586 and 0.601, respectively. The index system consisted of 2 first-level indexes and 21 second-level indexes. Conclusions A reliable and scientific risk factors evaluation index system for peri-operative hypothermia was developed. It can be utilized to provide theoretical foundation for the prevention of peri-operative hypothermia.

The prevalence of childhood primary hypertension is increasing each year,not only bring-ing symptoms to these children,but also causing damage to multiple target organs such as heart,kidney,blood vessels,eyes and nerve system. Childhood hypertension is a risk factor of adult hypertension. Paying atten-tion to and preventing childhood hypertension has become a public health challenge. There are many associat-ed risk factors for childhood primary hypertension,including parental hypertension,overweight and obesity, low birth weight,and so forth. From the analysis of these factors,suggestions can be given about how to pre-vent childhood primary hypertension.

The triggering receptor expressed on myeloid cells (TREM) -1 is a recently identified molecule involved in the inflammatory response.It belongs to the immunoglobulin superfamily,it was reported that it has relation with inflammatory response mediated by several microbial components,besides its soluble form was observed and identified at significant levels in bacterial infection of neonate.So it may become a valuable diagnostic marker of serious bacterial infection in neonate.

Objective To observe the clinical efficacy of grain-sized moxibustion in treating cancer-related fatigue and improving the quality of life of patients with malignant tumor. Method Forty-six patients with malignant tumor were randomized into a grain-sized moxibustion group and a control group. The grain-sized moxibustion group received grain-sized moxibustion plus regular treatment, while the control group received the regular treatment only. The cancer-related fatigue intensity [Karnofsky Performance Status (KPS), European Organization for Research on Treatment of Cancer Core Quality-of-life Questionnaire (EORTC QLQ-C30), Piper Fatigue Scale (PFS)], white blood cell count, hemoglobin level, lymphocyte count, and neutrophil count were compared before and after treatment between the two groups. The correlation between cancer-related fatigue and the observed indexes was also analyzed. Result The grain-sized moxibustion group was better than the control group in mitigating the cancer-related fatigue, up-regulating hemoglobin level, and improving the symptoms (P<0.05). Conclusion Grain-sized moxibustion can effectively mitigate cancer-related fatigue via improving anemia condition and the symptoms of malignant tumor patients, and it can also enhance the quality of life of the patients.

Objective To survye the relationshi p between blood pressure and body mass index ( BMI) ,waist-to-height ratio( WHtR) and body surface area( BSA) amogn 7 to 13 years old children in Jin-pan id strict,Haikou city.Methods A total of 1 018 school-age children aged from 7 to 13 years old were se-lected from two elementary schools in Jinpan distir ct,Haikou cti y.Blo odp ressure,height, weight and wa ist circumferencew ere measuredi n all children.BMI,WHtR,BSA were calculated and statistci al analyis s was performed by SPSS 22.0 software.Results The Pearson Correlation Coefficient of BMI and bloodp er ssure showed that BMI was posti vely correlatde with ob th systolic and id astoil c blood pressure(r=0.489,0.454, P<0.01,respective ly).The Pearos n Correlation Cofe ficient of WHtR and blood pressure showed that WHtR was positively correlated with both systolic and diastolic blood pressure(r=0.294,0.310,P<0.01,respec-tively) .The Pearson Correlation Coefficient of BSA and blood pressure showed that BSA was positively cor-related with both systolic and diastolic blood per ssure(r=0.603,0.520,P<0.01,respectively).The WHtR adn BSA of hypetr ension group were higher than those of the non-hypertension group( P<0.01) in both male and female children.Conclusion The blood pressure in 7 to 13 years old school-age children of Jinpan dis-trict,Haikou city is related to the BMI,WHtR and BSA respectively.

Aim To observe the effects of amlodipine on cell cycle,cell cycle-related genes and cyclin expression of human breast carcinoma MCF-7 cells.And to probe effects of amlodipine on cell cycle and its mechanism of human breast carcinoma MCF-7 cells.Methods In vitro growth inhibitory effects of amlodip-ine on human breast carcinoma MCF-7 cells were determined by MTT assay,cell cycle distribution was detected by flow cytometry,the Mrna expression levels of cell cycle-related genes cyclinD1 and p21 were treated by RT-PCR,and the protein expression of cell cycle protein cyclinD1 and p21 were assessed by Western blot.Results With dose and time dependently,amlodipine could inhibit the proliferation of human breast carcinoma MCF-7 cells in vitro.The IC_(50) was 14.439 μmol·L~(-1).When breast cancer cells MCF-7 were treated with 7.22 μmol·L~(-1)(1/2 IC_(50)),14.439 μmol·L~(-1)(IC_(50))and 28.88 μmol·L~(-1)(2IC_(50))amlodipine for 48 h,the ratios in the G_0/G_1 phase were significantly increased as compared with control group(P<0.05).Amlodipine inhibited the expression of Mrna and protein of cyclinD1,while increased the expression of Mrna and protein of p21.Conclusions Amlodipine exhibits obvious anti-tumor activities on human breast carcinoma MCF-7 cells and arrest cell cycle in G_1 phase.The mechanism of G_1 phase arresting may be related to modulating the Mrna and protein expression of cell cycle-related gene cyclinD1 and p21.

Objective To observe the changes of serum soluble form of triggering receptors expressed on myeloid cell-1 (sTREM-1) level in full-term newborns with infection and to investigate the relationship between serum sTREM-1 and neonatal bacterial infection.Methods Eighty-five full-term newborns admitted to the neonatal ward of Shanghai Children s Hospital of Shanghai Jiaotong University were selected into this study.According to the locations and severity of infection,patients were divided into 3 groups: severe infection group (n = 27),mild infection group (n = 28),non-infection group (n = 30).The samples of infection groups were collected before using antibiotics and within 48 h after infection symptom occurred; others were collected during hospitalization.For the neonates with organ dysfunction in the severe infection group,samples were also collected at the third and seventh day of infection.Serum sTREM-1 was measured by enzyme-linked immunosorbent assay.Analysis of variance was used to compare the difference between groups.Receiver operating characteristic (ROC) curve was used to calculate the sensitivity,specificity,positive and negative predictive value and Youden index.Results (1) Serum sTREM-1 level of severe infection group[(91.2±47.3) pg/ml] was significantly higher than that of mild infection group[(68.8 + 30.4) pg/ml] and non-infection group[(35.5±17.6) pg/ml],respectively (P＜0.05).(2) Serum sTREM-1 level of the survival newborns (n= 17) in the severe infection group was lower than that of dead ones[(73.1±34.9) pg/ml vs (121.6±49.3) pg/ml,t= - 2.995,P = 0.006].(3) For the survival patients,the serum sTREM-1 level decreased in the first week of infection,while that of dead patients increased,the cut-off value was 100.6 pg/ml.(4) Based on the ROC analysis,43.8 pg/ml was selected as the the cut-off value,area under the curve was 0.868,and sensitivity was 85.5%,specificity 80.0%,positive predictive value 0.887,negative predictive value 0.750,Youden index 0.655.Conclusions Serum sTREM-1 level increases in neonatal infection.The change of serum sTREM-1 level in patients with severe infection is correlated to the prognosis.

Objective To introduce three-dimensional management mode to manage the devices in the operating room so as to reduce the risks.Methods A three-dimensional quality control group was established to strengthen the devices management.From three dimensions of thinking,communication and action some measures were proposed including training for standardized operation and incident treatment,improving guidance,sticking warning signs,advocating active report of adverse events,preventive maintenance and etc.Efficacy inspection and continuous improvement were carried out.Results The examination scores,inspection results and active reports of adverse events were significantly different before and after the introduction of three-dimensional management mode.Conclusion Three-dimensional management mode,in which the three dimensions connect to and cycle through each other,makes nursing staffs progressively develop the habit of safe operation in an environment of safety culture.Three-dimensional management mode is a scientific and applicable management method to reduce risks in using the devices in the operating room.

Objective To evaluate and compare the value of interleukin(IL)-6,IL-8,tumor necrosis factor(TNF)-α,and soluble form of triggering receptor expressed on myeloid cells (sTREM)-1 in neonatal infection and detect the relationship between them.Methods Eighty-five full-term newborns who were admitted to the neonatal ward of Shanghai Children's Hospital of Shanghai Jiaotong University were enrolled,according to the locations and severity of infection,the patients were divided into three groups:systemic infection group (n =27),local infection group(n =28),and non-infection group (n =30).The level of plasma sTREM-1 was measured by enzyme-linked immunosorbent assay,and the levels of IL-6,IL-8 and TNF-α were measured using cytometric bead array.Results (1) The levels of sTREM-1,IL-6,IL-8 and TNF-α were significantly higher in infants with systemic infection group than local infection group and non-infection group(P ＜0.05).(2) There were 17 survivors and 10 deaths in systemic infection group,and the level of sTREM-1 in the non-survivor [(121.64 ±49.31) pg/ml] was higher than the survivor[(73.13 ± 34.92) pg/ml,P =0.006].But the levels of IL-6,IL-8 and TNF-α were not statistically significant in the survivor and the death (P ＞ 0.05).(3) Based on the receiver operating characteristic analysis,cutoff values were identified for each variable that maximized both the sensitivity and specificity.These markers were considered positive if sTREM-1 ≥43.75 pg/ml,IL-6 ≥ 89.80 pg/ml,IL-8 ≥569.55 pg/ml and TNF-α ≥ 24.80 pg/ml.Among these indexes,the sensitivities were 85.5％,89.1％,70.1％ and 69.5％ respectively; the specificity were 80.0％,100％,100％ and 93.3％ respectively.Compared the area under curve(AUC) of them,IL-6(AUC =0.981)＞ sTREM-1 (AUC =0.868) ＞ TNF-α (AUC =0.864) ＞ IL-8 (AUC =0.852).sTREM-1 was correlated with IL-6,IL-8 and TNF-α(Spearman coefficient of rank r =0.532,P ＜0.01 ;r =0.420,P ＜0.01 ;r =0.531,P ＜0.01).Conclusion (1) The levels of plasma sTREM-1,IL-6,IL-8 and TNF-α were higher in neonatal infections;(2) sTREM-1 was associated with prognosis; (3) sTREM-1 was correlated with IL-6,IL-8 and TNF-α.

Objective To understand the level of neonatal pain knowledge and attitudes of neonatal and obstetric department nurses, in order to supply the clinical basis for neonatal pain management. Methods Self-designed questionnaires to fill out on-site were distributed to 107 neonatal and obstetric department nurses (of which 40 were from neonatal department, 67 from obstetric department) for neonatal pain knowledge and attitudes. Results About question of neonatal pain, the average percentage of correct answers in the neonatal group was 75.5%, higher than 66.3% of the obstetric group, in the neonatal group, correct rate of seven questions was more than 80%,while in the obstetric group the correct rate of only one question was more than 80%, and 5 questions correct response rate was significantly lower than that of the neonatal group, the difference was significant. All nursing staff considered it essential or necessary to carry out the nursing knowledge of pain-related training. 95.0%(38/40) of neonatal nurses believed that they could properly assess the extent of neonatal pain, but only 83.6% (56/67) for the obstetric group, the difference between the two groups was significant. 97.5% (39/40) of neonatal nurses believed that they could make the right judgments on neonatal crying, and only 85.1%( 57/67) in the obstetric nurses, the difference between the two groups was significant.Conclusions Neonatal pain has gradually been recognized and paid attention to by the clinical front-line medical staff, they believe that it is necessary to receive training on neonatal pain, knowledge of neonatal pain of neonatal nurses is better than obstetric nurses.