Objective To investigated the role of antithrombin Ⅲ (AT-Ⅲ) levels in the early diagnosis of disseminated intravascular coagulation (DIC) in patients with sepsis and the predictive effect of AT-Ⅲ on the development of DIC.Methods A retrospective study was conducted. Patients admitted to intensive care unit (ICU) of the First Affiliated Hospital of China Medical University from January to December in 2015 were enrolled. The patients were divided into sepsis group and non-sepsis group according to the diagnostic criteria of sepsis. In addition, sepsis patients were divided into 3 subgroups according to the international society on thrombosis and haemostasis (ISTH) scores on the first day: overt DIC (ISTH ≥ 5), non-overt DIC (ISTH 1-4) and none DIC group (ISTH = 0). Blood routine test, prothrombin time (PT), fibrinogen (Fib), D-dimer, fibrin degradation products (FDP), acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) scores, sequential organ failure assessment (SOFA) scores and ISTH scores were recorded on the first ICU day. AT-Ⅲ was recorded during 7 days. The differences were compared among these 3 groups. Correlations of AT-Ⅲ with various parameters were calculated by using Pearson correlation analysis in sepsis group and overt DIC group. Receiver operating characteristic (ROC) curves for diagnosis of DIC with AT-Ⅲ, AT-Ⅲ+PT were drawn to evaluate the diagnostic efficiency. The AT-Ⅲ levels of DIC patients were compared between early-onset DIC and late-onset DIC during their ICU stay. The change of AT-Ⅲ levels with time and prognosis in patients with early-onset DIC was compared between groups.Results Totally 445 patients were recruited, with 138 patients in sepsis group, and 307 in non-sepsis group. There were 20 patents diagnosed with overt DIC on the first ICU day, 115 patients non-overt DIC and 3 patients of none DIC. Twenty-five sepsis patients were diagnosed overt DIC during the ICU days. AT-Ⅲ level in sepsis patients on the first ICU day were lower than that in non-sepsis patients [(55.29±13.92)% vs. (76.54±12.31)%,P < 0.01]. Patients with overt DIC had a lower AT-Ⅲ level than non-overt DIC or none DIC patients [(43.85±13.00)% vs. (56.95±13.03)%, (68.00±16.52)%, bothP < 0.05]. It was shown by Pearson correlation analysis that AT-Ⅲ level of sepsis patients on the first ICU day was negatively correlated to ISTH score and PT (r value were -0.467, -0.654, bothP < 0.01). AT-Ⅲ level of overt DIC patient on the first ICU day was negatively correlated with PT (r = -0.675,P = 0.001). It was shown by ROC curve that area under ROC curve (AUC) of AT-Ⅲ combined with PT for diagnosis overt DIC in sepsis patients was higher than that of AT-Ⅲ or PT alone (0.843 vs. 0.763, 0.834), the sensitivity 90.0%, specificity 73.7%. The cut-off value for overt DIC diagnosis in sepsis patients of AT-Ⅲ level alone was 48.5%, sensitivity was 78.0%, specificity was 70.0%. On the first ICU day, AT-Ⅲ level was risen when ISTH score improved in patients with sepsis. There was similar change of AT-Ⅲ level between patients with early-onset DIC and late-onset DIC. AT-Ⅲ level increased with DIC improvement.Conclusion AT-Ⅲ level can be used for diagnosing sepsis-associated overt DIC independently or with a combination of PT. When ISTH score improved, AT-Ⅲ level was risen in patients with sepsis associated DIC.

Objective To investigate the content of intestinal fatty acid binding protein (IFABP) and its clinical significance in patients with severe sepsis.Methods A prospective observational study was conducted.Fifty patients with severe sepsis admitted to intensive care unit (ICU) of the First Affiliated Hospital of China Medical University from July to December 2012 were enrolled,and 20 healthy patients served as control group.The concentrations of serum IFABP,interleukin-6 (IL-6),and tumor necrosis factor-α (TNF-α) were determined with enzyme-linked immunosorbent assay (ELISA) on days 0,1 and 3 after ICU admission.Acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) and sequential organ failure assessment (SOFA) score,28-day prognosis,acute gastrointestinal injury (AGI) grade were recorded at the same time.Furthermore,the contents of IFABP were compared between control group and the severe sepsis group,abdominal infection group and non-abdominal infection group,the survival group and the death group,as well as among different AGI-grade groups.Correlation analysis of IFABP and inflammatory factors,IFABP and two scores,and IFABP and time of stay in ICU and mechanical ventilation were studied.Multivariate logistic regression and analysis of 28-day outcome of the patients were also studied.Results IFABP levels were increased in severe sepsis patients on days 0,1 and 3 compared with those of healthy control group (mg/L:731.90 ±53.91,592.07 ±41.94,511.85 ±47.97 vs.439.88 ±23.68,all P =0.000).There was no statistical significance of IFABP levels between abdominal infection group and non-abdominal infection group,the survival group and the death group,or among different AGI-grade groups.The correlation analysis showed that IFABP was statistically related with IL-6 (r=0.794,P=0.000),TNF-α (r=0.878,P=0.010),APACHE Ⅱ score (r=0.428,P=0.000) in patients with severe sepsis.Significant correlations were also found between IFABP and IL-6 (r=0.812,P=0.000),TNF-α (r=0.885,P=0.000) in abdominal infection group,as well as in non-abdominal infection group (IL-6:r=0.739,P=0.000; TNF-α:r=0.828,P=0.000).As shown by multivariate logistic regression analysis,SOFA scores on days 0,1,3 were the independent risk factors for death [odds ratio (OR) was 1.624 (P=0.004),1.411 (P=0.027),1.740 (P=0.012),respectively],but IFABP level,AGI grade,and APACHE Ⅱ score had no influence on death rate.Conclusion IFABP concentrations in patients with severe sepsis were significantly increased,and it is correlated well to IL-6,TNF-α and APACHE Ⅱ score,but did not related obviously with AGI grade and the prognosis of the patients.

Objective: To understand the epidemiological characteristics of pulmonary tuberculosis (PTB) in Shaanxi Province from 2016 to 2021, so as to provide the basis for improving PTB prevention and control strategies. Methods: The incidence data of PTB cases in Shaanxi Province were collected from the Tuberculosis Information Management System of the Chinese Disease Prevention and Control Information System from 2016 to 2021. The temporal, geographical, and demographic distribution characteristics of PTB were described. Results: A total of 121 280 PTB cases were reported in Shaanxi Province from 2016 to 2021, with the reported incidence rate decreasing from 56.30/105 in 2016 to 40.98/105 in 2021 (P<0.05). The etiological positivity rate increased from 16.61% in 2016 to 54.37% in 2021 (P<0.05). The average annual number of reported cases peaked in March (1 984.67 cases, accounting for 9.81%), followed by January (1 885.50 cases, accounting for 9.33%), and hit its lowest in October (1 458.50 cases, accounting for 7.22%). The incidence of PTB was relatively high in northern Shaanxi and southern Shaanxi, at 67.99/105 and 64.05/105, respectively, while it was relatively low in Guanzhong Region, at 44.83/105. The incidence rates of Ankang City (85.81/105), Fugu County (73.92/105), and Yulin City (72.20/105) ranked the top three. There were 80 111 male cases and 41 169 female cases of PTB, with a male-to-female ratio of 1.95︰1. The reported incidence rate of males (67.38/105) was significantly higher than that of females (36.61/105), and the difference was statistically significant (P<0.05). Among males, the highest average reported incidence rate was found in the 80 to <85 age group (179.46/105), while among females, the highest was in the 75 to <80 age group (104.38/105). The main occupations were farmers, accounting for 68.87% (83 526 cases). Conclusions The reported incidence rate of PTB in Shaanxi Province showed an overall downward trend from 2016 to 2021, with a high incidence in winter and spring. The epidemic in southern Shaanxi and northern Shaanxi is more severe than in Guanzhong Region of Shaanxi Province. The incidence of PTB is predominantly found among males, the elderly, and farmers.

Objective To investigate the effects and mechanisms of Alpinia oxyphylla fructus (AOF) on learning and memory in D-galactose induced brain aging mice. Methods The brain aging model was induced by s. c D-galactose. Learning-memory ability was tested by passive avoidance test and Morris water maze test, and the expression of synapsin ( Syn), mitogen-activated protein kinase (MAPK) and protein kinase ( PKC ) in hippocampus were examined by Western blot. Results ① Passive avoidance test:the latency in brain aging group( ( 119.80 ±101.80)s) significantly decreased,and the number of errors (4.4 ± 1.3 ) significantly increased compared with the control group( latency: (279.30 ± 31.64) s; number of errors: ( 1. 8 ±0.9), P＜0. 01 ) ). The latency in low dose, middle dose and high dose AOF group( ( 170.25 ± 68.31 ) s, (226.31 ± 73.25 ) s, (263.20 ± 70.55 ) s) significantly increased, and the number of errors in middle dose and high dose AOF group ( ( 2.8 ± 1.2 ), ( 2.3 ±0. 9 ) ) significantly decreased compared with brain aging group (P ＜ 0. 05, P ＜ 0. 0 1 ). ② Morris water maze test:the escape latency in brain aging group was significantly longer, and the time spent in the original quadrant that previously contained the platform was significantly shorter compared with the control group (P＜0. 01 ). The escape latency in 3 AOF groups was significantly shorter (P＜ 0. 05 ), and the time spent in the original quadrant that previously contained the platform in middle and high dose AOF groups was significantly longer compared with brain aging group (P＜0. 05, P＜0. 01 ). ③ Western blot test:the expression of Syn,MAPK and PKC in hippocampus of brain aging group was significantly weakened than that of the control group. In contrast, the expression of Syn,MAPK, PKC were significantly enhanced in all AOF groups. Conclusion AOF could significantly improve the ability of learning and memory in brain aging mice. Its effects might be related to the increase of the expression of Syn, MAPK and PKC in hippocampus.

Objective To explore the relationship between operation scores and the expression of caveolin-1 ( Cav-1 ) protein in the cortex of mice.Methods Male Kunming mice were used and divided into two groups (excellent group and bad group) according to the training scores after 4 days' Y-maze learning training.The expression of cav-1 protein in cortex and hippocampus of the mice with different scores were measured through Western blot technology.Results Cav-1 protein expression of excellent group( Cav-1/β-actin was 5.71 + 1.11 ) in the cortex was significantly higher than that of the bad group ( Cav-1/β-actin was 1.69 + 0.20) (P ＜ 0.01 ).While there was no significant difference in the two groups in the expression of Cav-1 protein in hippocampus(P ＞ 0.05 ).Conclusion The operation scores have distinct correlation with the expression of Cav-1 protein in the cortex of mice.

Objective To improve the accuracy of prescription checking and provide reference for rational drug administration. Methods Intervention mistakes exsisting in prescription checking in 2016 were retrospectively studied to analyze pharmacist' s misunderstanding during prescription checking. Results The error rate of prescription intervention was higher in department of cardiology, department of general internal medicine and department of neurology, accounting for 0.6％, 0.24％ and 0.23％, respectively.Inaccurate prescriptions for intervention, inaccurate medication and inaccurate repeat injections ranked the top 3 of erroneous prescriptions, with the proportions of 25.11％, 22.98％ and 17.45％, respectively. Conclusion Pharmacists should regularly summarize the misconceptions existed in the prescription audit, take individualized medication thoughts as guidance, strengthen the multi-disciplinary knowledge learning.

After freeze-drying, the ultrastructure of boar sperms was observed by optical and electron microscopy. The in vitro development ability of the sperm was also examined with intracytoplasmic sperm injection (ICSI). The rate of male pronuclear formation was (68.52%), for cleavage (59.17%) and for blastocyst formation (19.16%) of the trehalose group (0.2 mol/L), significantly higher than those of the 50 mmol/L EDTA group (64.59%, 56.26% and 15.62%) and the control group (35.36%, 52.33% and 8.60%) (P < 0.05). After storage for 60, 120 and 180 d at 4 degrees C, no significant difference in the in vitro development was observed (P > 0.05). The male pronuclear, cleavage and blastocyst formation after ICSI with freeze-dried spermatozoa incubated for 1 h was superior than those incubated for 2 h (P < 0.05). No significant differences in the structures after stored at 4 degrees C or -20 degrees C (P > 0.05) were observed between the trehalose group and EDTA group. The percent of B grade freeze-dried boar spermatozoa in the trehalose group was higher than that of the EDTA group (P < 0.05). Based on the ultrastructure observation, main cryogenic damage in freeze-dried boar spermatozoa was swelling, damage or rupture in the sperm acrosome, neck and tail.
Animals ; Freeze Drying ; Male ; Semen Preservation ; methods ; veterinary ; Sperm Injections, Intracytoplasmic ; veterinary ; Spermatozoa ; Swine ; Trehalose ; pharmacology

Objective To evaluate Chinese nurses' perception of the nursing work environment and to compare the differences among the eight economic regions in mainland China.Thus,policy-makers and nursing managers can optimize and coordinate resources based on the results of this study.Methods Chinese version of Nursing Working Environment Scale was used in the study.A total of 19,000 nurses from 31 provinces and municipalities in mainland China were investigated.Descriptive analysis,cluster analysis and nuclear density estimation were conducted.Results The average score of the nursing work environment was 4.1 points,which means nurses were somewhat satisfied with their work conditions.Specifically,nurses were most dissatisfied with the basic safeguard dimension (3.4 points),followed by sufficient manpower (3.9 points),career development (4.0) and leadership and management(4.0)dimensions.In addition,the eight economic regions could be divided into three categories(P＜0.01)according to the differences of the nursing work environment.The first category included the northeast,northern coastal and middle reaches of the Yellow River economic zone;the second category included eastern coastal economic zone;and the third category included the southern coast,the middle reaches of the Yangtze River,southwest and northwest economic zone.Conclusion The development of the nursing work environment in the vast majority of mainland China is unbalanced and the regional differences are obvious.

Objective To explore whether Rho kinase inhibitor protects endotoxemia mice from kidney injury,and to investigate the mechanism underlying this effect. Methods Adult male C57BL/6 mice were randomly divided into three groups (n = 8 for each group): control,lipopolysaccharide (LPS),and LPS+ Y-27632 (Rho kinase inhibitor). For induction of acute kidney injury,mice were administered 30 mg/kg LPS intraperitoneally. Y-27632 (10 mg/kg body weight) was injected intraperitoneally 18 h and 1 h before injection of LPS,and an equal volume of sterile saline was administered at the corresponding time point in each group. The mice were killed 8 h after LPS administration. Blood samples and kidney tissues were taken and preserved for subsequent analysis. Results Pretreatment with Y-27632 significantly attenuated LPS-induced kidney injury;pretreatment with Y-27632 markedly reduced renal expression of inflammatory cytokines (TNF-α and IL-1β) in endotoxemia mouse,and also significantly inhibited LPS-induced caspase-3 expression in the kidney; and Y-27632 pretreatment dramatically reduced TLR4 protein expression and NF-κBp65 phosphorylation in kidney tissues of endotoxemia mouse. Conclusion Rho kinase inhibitor may inhibit TLR4 and NF-κB signaling pathway to reduce the inflammatory response in the kidneys of endotoxemia mice and alleviate acute renal injury induced by LPS.