Objective To study the impact of therapy strategy on outcomes of patients suffering from severe sepsis and/or septic shock. Method A total of 195 patients diagnosed as severe sepsis or septic shock were enrolled for prospective study from June 2008 to December 2009. Patient's clinical manifestation,treatments and outcomes were studied by using SSC database. Patients were divided into control group and treatment group. In control group, patients enrolled from June 2008 to December 2008, were treated with conventional medical care In treatment group, patients enrolled from January 2009 to December 2009 were treated with a novel algorithm of mandatory treatment for sepsis In-hospital mortality of two groups was compared. SPSS15.0 software was used for analysis of data. Chi-square test and unpaired t-test were used for comparisons between groups. Results Compared to the control group The need for blood lactate test was significantly grown in treatment group [98.2% (115/117) versus 2.56% (2/78), P ＜ 0.001]. Antibiotics was administered to 69.2% (81/117) patients of treatment group within 3 hours after their arrival at the emergency department compared to 35.8% (28/78) in the control group (P ＜ 0. 001). Blood cultures made before antibiotics given were 47.9% (56/117) in the treatment group compared to the control group 25.6%(20/78), P = 0. 003. The rate of fluid resuscitation was 80.3% (53/66) in the treatment group and 27%(10/37) in the control group, P ＜0.001. The rate of CVP (8 mmHg was 27.3% (18/66) in the treatment group and 8.1% (3/37) in the control group, P = 0. 023. In-hospital mortality was 29.1% (34/117) in the treatment group and 44.8% (35/78) in the control group, P =0. 032. Conclusions The algorithm of mandatory treatment for sepsis improved the therapeutic efficacy of the treatment for severe sepsis and septic shock, decreasing in-hospital mortality.

Objective To find out the relativity of diseases and emotional factors,provide foundation for the clinical epidemiologic survey,and to know about the doctors understanding of emotional etiology.Method Consulting to the diagnostic criterion of emotional diseases,whole-team-delamination method was adopted to research 54 703 registered case history of retrospective etiology in hospitals(Established Hospital of Shandong Province,Jinan City Central Hospital,TCM Hospital of Shandong Province) within 3 years.Result The cases that was related to emotions were totally 506,0.92% of all the cases.Of all the positive cases,62.5% of them were cardicvascular diseases,12.06% were digestive diseases,3.56% were gynecologic diseases.Of all the emotional etiology,agitation was 43.87%,anger was 25.69%.Female patients took up 56.72% of all the positive cases.Conclusion Cardiovascular diseases are more related to negative emotions,the basic emotion"anger"is more related to diseases,female is prior to male patients,age is of positive correlation of the occurrence of emotional diseases.

Objective To introduce and translate the Coping-adaptation Processing Scale:Short Form-15 items (CAPS:SF) and evaluate the reliability and validity among people after losing the only-child. Methods CAPS:SF was translated into Chinese (CV-CAPS:SF) according to Brislin. A sample of 77 people after losing the only-child were recruited to complete the scale to evaluate the reliability and validity of scale. Results The scale-content validity index of the CV-CAPS:SF was 0.94;the Cronbachαwas 0.85 and split-half coefficient was 0.84. The score of coping was (38.60 ± 5.30) points. The take strength from spirituality or the successes of courageous people was the highest (3.44±0.50) points;the use humor in handling the situation was the lowest (2.05±0.58) points. Different age, education degree, marital status, occupation, average monthly income of latest year, the length after losing the only-child in the face of the difference was statistically significant (t/F=7.636-85.130, all P<0.05). Conclusions The CV-CAPS:SF is reliable and valid. It could be used to help the nursing staff understand coping among people after losing the only-child .

Chitosan and it's derivatives have good biologic and particular physical and chemical properties. They have a wide applied foreground on drug preparations. This study introduced the recent advances of them based on widely researching the information and the actual works, and provided reference for the study of oral drug preparations.

Objective NAC therapy was used to observe the effect of TNF-?,hs-CRP,PaO2,PaCO2and lung function in patients with COPD,so as to evaluate the therapeutic effect. Methods 65 patients with COPD were recruited and the patients were randomly divided into 2 treatment groups:control group (n=31) and experimental group (n=34). Patients in the two groups received the conventional treatment of COPD in unchanged dosage for the duration of the study except stopping using antibotic drug after infection was resolved. NAC tablets were taken orally at a dose of 600mg once a day in experimental group. After 8 weeks treatment,we appraised lung function and the plasma level of TNF-?,hs-CRP,PaO2 and PaCO2. Results Compared with normal controls,the plasma levels of TNF-? and hs-CRP increased significantly. The higher level of those ,the higher lung function class was in 65 COPD patients,and there was significant effect(P

Objective To investigate the direct economic loss caused by oral infection in patients with acute leuke-mia.Methods Acute leukemia patients with oral infection in a tertiary first-class hospital in Shandong Province be-tween January 2011 and December 2013 were investigated,the 1 :1 matched case-control method was used for com-paring hospitalization expense and length of hospital stay between oral infected (case group)and uninfected patients (control group ).Results A total of 994 patients with acute leukemia were monitored,277 had healthcare-associated infection,17 (5.56%)of whom were with oral infection.The median hospitalization expense of patients in case group and control group was￥37 327 and￥13 176 respectively,the total hospitalization expense of patients in case group was 2.83 times more than control group,difference was statistically significant (Z = -3.621 ,P <0.001).Each hospitalization expense of case group was higher than control group,especially expense for medicine, blood transfusion,laboratory examination,and therapy.The median length of hospital stay in case group and con-trol group were 17 days and 11 days respectively,rank sum test showed that difference in median length of hospital stay between two groups was statistically significant (Z =-3.627,P < 0.001 ).Conclusion Acute leukemia pa-tients with oral infection have increased hospitalization expense,prolonged length of hospital stay,and increased the financial burden.

Objective To investigate the anti-fibrotic effect of Kudancao tablets on bleomycin-induced pulmonary fibrosis in rats . Methods Forty healthy adult SD rats(200±20g)were randomly divided into 4 groups: normal control group(without any treatment),normal saline group(intratracheal instillation of normal saline), model group(intratracheal instillation of 5mg/kg of Bleomycin)and kudancao tablets group(intragastric administration of kudancao tablets suspended in normal saline,0.705g/(100 g.d),2 times/day and for 5 times, then intratracheal instillation of 5 mg/kg of Bleomycin 1h later). Rats in all groups were scraficed 14d and 28d after intratracheal instillation. Alkali hydrolysis method was used to detect the HYP content in lung tissues. The pathological changes were observed with HE staining and silver staining. ResultsCompared with the normal control group and normal saline group,the HYP content in the lung tissues of rats in model group increased significantly (P<0.01). Compared with the model group,the HYP content in the lung tissues of rats in kudancao tablets group decreased significantly(P<0.01). Pathological examination showed that significant fibrotic changes were found in lungs of rats in model group,while the fibrotic changes were ameliorated in lungs of rats in kudancao tablets group. ConclusionKudancao tablets may decrease the hydroxyproline content in lung tissues,and ameliorate the fibrotic degree of lungs of rats with bleomycin-induced pulmonary fibrosis.

Objective To investigate the direct economic losses caused by healthcare-associated infection(HAI)in patients with acute lymphoblastic leukemia (ALL)and acute non-lymphoblastic leukemia (ANLL).Methods All acute leukemia (AL)adult patients who were admitted to a hematology ward in a hospital between January 201 1 and December 2013 were included in the study,HAI group(case group)and non-HAI group (control group),ALL group and ANLL group were matched respectively in a 1:1 ratio,hospitalization expenses and length of hospital stay were compared.Results A total of 994 patients were included,166 were with ALL,828 with ANLL,there were 181 pairs of case group and control group,and 15 pairs of ALL group and ANLL group. Direct economic los-ses in ALL group and ANLL group were 13 089.0 ￥ and 21 565.0 ￥ respectively ;extension of length of hospital stay due to HAI were 10.5 and 10.0 days respectively,differences were statistically significant between case group and control group (both P<0.05). The total hospitalization expense,as well as fees for bed,consultation,treat-ment,laboratory examination,nursing,medicine,traditional Chinese medicine,and blood transfusion in ANLL group were all higher than ALL group,but there were no significant difference.Conclusion HAI in patients with AL can increase hospitalization cost and prolong length of hospital stay.

Objective To study the correlation of mitochondrial DNA mutation of spermatozoa and change of mitochondria-ultrastructure with male infertility. Methods The techniques of PCR and DNA sequence analysis were used to detect MTCYB and MTATP-6 fragments of 76 samples of semen with poor motility from infertile male.Of these samples five were identified with mitochondrial DNA deletion and transmission electron microscopic observations were made. Results Under the electron microscopic observations the 5 samples were all seen with abnormal volume of mitochondria in most spermatozoa tails either small or big, disorderly located and asymmetrically distributed;the axonemal structures of sperm wrapped in layers of mitochondria. These samples of sperm were noticeably different in form from those from fertile male. Conclusion Sperm mitochondria-ultrastructure change were observed in samples of sperm mitochondrial DNA mutation.Sperm mitochondrial mutation and its mitochondria-ultrastructure affect the energy supply of sperms during the process of fertilization which may result in male infertility.;

Objective To master iodine intake ways of children in Yancheng (coastal) and Zhenjiang (inland) cities,analyze their urinary iodine difference and provide solid evidence for adjustment of salt iodine and adequate iodine intake level of local residents.Methods Totally 50％ counties were randomly selected in Yancheng and Zhenjiang cities and 5 towns were sampled in each county in 2014,local water iodine,domestic salt iodine,local eating habits and urine iodine of children 8-10 years old were investigated,and the influences of different iodine intake ways on urine iodine level were analyzed.Results The median of water iodine was 4.76 μg/Lin Zhenjiang (n =40) and 50.80 μg/L in Yancheng (n =50),the difference was statisticelly significant in two cities (Z =6.93,P ＜ 0.05).Totally 2 400 salt samples were tested,the mean of salt iodine was (24.20 ± 5.07) mg/kg in Yancheng (n =1 500) and (22.87 ± 2.77) mg/kg in Zhenjiang (n =900),the difference was statisticelly significant in two cityies (t =7.23,P ＜ 0.05).The salt intake level in Zhenjiang (10.69-± 9.00) g/d appeared to be higher than that in Yancheng (8.40 ± 3.57) g/d,but the difference was not statistically significant (t =1.62,P ＞ 0.05).Totally 1 200urine samples were tested,the urine iodine level of Zhenjiang got higher results (265.83 μg/L,n =450) than that of Yancheng (182.15 μg/L,n =750,Z =12.18,P ＜ 0.05).The ratio of water iodine intake/salt iodine intake was about 1 ∶ 4 in Yancheng and 1 ∶ 50 in Zhenjiang,while residents in Zhenjiang got 21％ of daily iodine through extra ways.Eating habits like eating out did not have significant impact on urine iodine.Conclusions Based on the water iodine level,Yancheng is considered to be a appropriate iodine level area while Zhenjiang is a lack region.However,Zhenjiang has a higher urine iodine level than Yancheng,which is more than adequate to the recommendation.Salt iodine is a main iodine source in both cities.In iodine appropriate and deficiency areas,eating habits and food choices may play a more important role than geochemical factors in iodine intakes among residents.