Objective To evaluate diagnostic value of Sonoclot in the diagnosis of heat stroke complicated with disseminated intravascular coagulation (DIC). Methods 43 patients with heat stroke and coagulation dysfunction were retrospectively included and divided into 2 groups according to scores by International Society of Thrombosis and Hemostasis (ISTH): DIC dominant group (22 case) and DIC non-dominant group (21case). Regular coagulation tests , routine blood test , D-dimer and Sonoclot tests were performed at admission and their clinical data were compared. Logistic regression analysis was applied to evaluate the relationships between DIC occurrence and Sonoclot parameters. ROC curves were used to evaluate diagnostic value of Sonoclot for the patients with DIC and heat stroke. Results There were no differences in age, sex, central temperature and total hospital stay between the 2 groups except ICU stay, DIC symptoms, outcome, ISTH scores and APACHEⅡscores (P <0.05). ACT and CR correlated with the occurrence of DIC (P < 0.05). The AUC of ACT and ACT combined with CR were 0.854 and 0.877 respectively. The specificity of ACT in predicting DIC was 69.2%with the sensitivity of 90.3%. When combined with CR, both the specificity and the sensitivity were increased to 80.2% and 93.5%, respectively. Conclusions Sonoclot can predict DIC quickly and is effective in the diagnosis of heat stroke patients with DIC.

Objective To investigate the status of self-management of elderly patients with chronic heart failure (CHF) in Xinjiang Region,and to explore the effects of different demographic factors on self-management.Methods A total of 704 patients with chronic heart failure were randomly selected from Urumqi,Kashgar,Khotan,Changji,Shihezi,Yili Hazakh in Xinjiang Uygur Autonomous Region via convenience sampling method and were investigated using heart failure self-management scale.Results The total score of self-management of chronic heart failure elderly patients was(47.6±11.1) and scoring rate was 59.5％.There were statistically significant differences(P＜0.01) in self-management score among patients with different ethnicity,religion,self-care ability,per capita income.The influencing factors of self-management were self-care ability,NYHA class and per capita monthly income(P＜0.05).Conclusion The overall level of self-management of elderly patients with chronic heart failure in Xinjiang Region is low,and self-management is affected by self-care ability,NYHA class and per capita monthly income.Tailored culture-based education should be provided to improve patients' self-management.

ObjectiveTo investigate the temporal features of renal injury in rats with severe heat stroke (SHS) and their relationship with inflammatory response.Methods Fifty-six male Wistar rats were randomly divided into normal control group and SHS for 0, 2, 6, 24, 48, 72 hours group (SHS-0, 2, 6, 24, 48, 72 h groups), with 8 rats in each group. Rats were placed in an artificial climate chamber [temperature (39.5±0.2)℃, humidity (60±5)%] to induce SHS model, and the criterion for successful model reproduction was the onset of lowering peak systolic blood pressure (SBP). Then the rats were transferred to room temperature (23.0±0.2)℃ after successful reproduction of the model. The rats of normal control group were kept in room temperature of (23.0±0.2)℃. Heart blood and renal tissue samples were harvested, and the levels of serum creatinine (SCr) and blood urea nitrogen (BUN) were determined by automatic biochemistry analyzer. The levels of myeloperoxidase (MPO), tumor necrosis factor-α(TNF-α) and interleukin-6 (IL-6) in renal tissue specimens were determined by enzyme linked immunosorbent assay (ELISA). The changes in histopathology in kidney were observed with light microscopy, and Paller scores were used to assess the degree of renal injury.Results Compared with normal control group, the levels of SCr and BUN in serum, and MPO, TNF-α and IL-6 in the renal tissue homogenate were significantly increased in SHS-6 h group [SCr (μmol/L): 174.0±27.0 vs.68.0±11.3, BUN (mmol/L): 12.6±2.3 vs. 4.3±1.2, MPO: (203.0±38.0)% vs. (100.0±1.4)%, TNF-α: (121.0±16.0)% vs. (100.0±1.4)%, IL-6: (118.0±19.0)% vs. (100.0±1.3)%, allP< 0.05], and they peaked at 24 hours [SCr (μmol/L): 489.0±96.0 vs. 68.0±11.3, BUN (mmol/L): 19.3±5.7 vs. 4.3±1.2, MPO: (511.0±41.0)% vs. (100.0± 1.4)%, TNF-α: (399.0±47.0)% vs. (100.0±1.4)%, IL-6: (473.0±56.0)% vs. (100.0±1.3)%, allP< 0.01], then declined to the normal levels at 72 hours. Under light microscopy, tissue edema and necrosis of renal tubules were found, and leukocyte infiltration was found to be most profuse at 24 hours, then they returned to normal levels at 72 hours. Paller scores in SHS-6 h group were significantly higher than those of the normal control group (75.45±9.70 vs. 14.23±3.26,P< 0.01), and it peaked at 24 hours (186.00±14.25 vs. 14.23±3.26,P< 0.01), followed by a gradual lowering, back to normal level at 72 hours.ConclusionThe results suggest that progressive renal damage occurred in the rats with SHS within 24 hours, and it was accompanied with elevated levels of MPO, TNF-α and IL-6 in the kidney homogenate, suggesting that inhibition of neutrophil activation and the release of IL-6, TNF-α may protect the SHS associated renal injury.

Objective To explore the effects of target value management for quality control indexes in chest pain center on the efficiency and effectiveness of in-hospital treatment for STEMI patients.Methods The database of Chest Pain Center in General Hospital of Guangzhou Military Command was retrospectively analyzed.STEMI patients who visited our hospital from March 2011 to March 2018 were selected as the research subjects.During the review period,the target values of quality control indexes were adjusted 4 times.Before and after the 4 adjustment,the efficiency indexes of in-hospital treatment STEMI patients were compared,including the first medical contact to the first electrocardiogram (FMC2ECG) time,catheter lab activation time and Door-to-Balloon (D2B) time.Length of hospital stay,in-hospital mortality and hospitalization cost were compared as well.Results A total of 332 STEMI patients were included in the study.As the quality control target values became stricter,the median and the average value of FMC2ECG time,catheter lab activation time and D2B time showed a downward trend.Among these data,the D2B time decreased from 95 (74,134.5) min to 50 (44.5,71) min,and its differences were of the most significance.However,there is no significant difference in the hospitalization cost,length of hospital stay and in-hospital mortality of STEMI patients.Conclusions The target value management of quality control indexes can improve the in-hospital treatment efficiency for STEMI patients,but the improvements of treatment efficiency and effectiveness cannot be immediately revealed.It takes a certain amount of time and needs enough cases to reach a significant difference.

Objective:The aim of the study was to develop a transcultural adaptation of Scrub Practitioners ′ List of Intraoperative Non-technical Skills to Chinese. Methods:The translation of SPLINTS was based on the Brislin ′s translation model and expert consultation were conducted for cultural adaptation before the Chinese version was accomplished. The content validity of Chinese version scale was evaluated by Delphi method. The applicability and observer reliability of the tool was tested by behavioral observation of simulate videos. Results:The positive coefficients of experts in the first and second rounds were both 100% and the authority coefficients were 0.802 and 0.906 respectively. The concordancy coefficients of expert Kendall were 0.282-0.433( P<0.05). The results of Delphi expert consultation showed that the average content validity index (S-CVI/Ave) of the scale level was 0.93, and the item level (I-CVI) content validity index was 0.87-1.00. The rater training showed that the intra-observer reliability was 0.75-0.96 and inter-observer reliability (Kendall W) was 0.502-0.557( P<0.01). Conclusion:The cross-cultural adaptation of SPLINTS-Chinese version is scientific and reliable. The content validation and observer reliability are in-line with scale evaluation criteria. Further psychometric measurement can be conducted in the group of scrub nurses in the operating room.

Objective: To study the age of onset of malignant tumors in cancer registration areas in Zhejiang province from 2000 to 2015. Methods: Based on the incidence data of cancer from 14 national cancer registration areas in Zhejiang province between 2000 and 2015, the incidence rate, average/standardized average age of onset, and age-specific incidence proportion were calculated, and standardized by Segi′s world population. The population was divided into 7 age groups (0-29, 30-39, 40-49, 50-59, 60-69, 70-79, ≥80 years old). The average age of onset and age-specific incidence proportion were analyzed by using a linear regression. The change trend of the proportion; the average annual percent change (AAPC) of the incidence rate was calculated by using the Joinpoint log-linear regression model. The birth cohort was constructed by using the standardized incidence rate and the year of onset of cancer, and the distribution characteristics of the age groups were described. Results: From calendar year 2000 to 2015, the average age of onset of malignant tumors in Zhejiang Province decreased from 59.7 to 57.6, with an average annual percent decrease of 0.09 year (P=0.033). After the merge of age groups, the standardized incidence proportion of 30-49 and ≥60 years old group standardization increased by an average annual change of 0.38% and decreased by an average annual change of 0.39%, respectively (both P values <0.001). The results of the log-linear regression model showed that the standardized incidence rate of the 30-39 and 40-49 years old age groups increased rapidly, with the AAPC (95%CI) about 5.2% (4.4%-6.0%) and 3.4% (2.5%-4.3%), respectively. The incidence rate of female increased rapidly, especially for 30-39 and 40-49 years old age groups with the AAPC about 6.2% (5.1%-7.2%) and 4.9% (4.0%-5.9%), respectively. The results of the birth cohort analysis showed that the population with different birth years in the same age groups saw an increasing trend with the increase of the birth year. Conclusion The age of onset of malignant tumors in the cancer registration areas in Zhejiang Province is getting younger. The incidence rate and number of people with malignant tumors in 30-49 years old age group is evident. These characteristics are more obvious in female than that in male.

The concept and the importance of non-technical skills, relevant influence factors and assessment tools were reviewed. Introduction of non-technical skills measuring tool used at home and abroad from object, content, evaluation method, the result and the application status, then puts forward thinking for the lack of assessment tools. To evaluate the present situation of non-technical skills of the surgical team and members as well as to offer suggestion to improve training effect.

Objective:To evaluate the quality of life (QoL) of Chinese chronic pancreatitis (CP) patients based on the Chinese version of the pancreatitis quality of life Instrument (PANQOLI) and explore its impact factors.Methods:404 patients with CP admitted to the Department of Gastroenterology of the First Affiliated Hospital of Naval Medical University between September 2021 and January 2022 were enrolled. The Chinese version of PANQOLI was used for questionnaire survey on QoL of CP patients. Univariate analysis and multiple linear regression analysis were used to explore the impact factors for QoL of CP patients.Results:The total score of QoL of 404 Chinese CP patients was 28-94(72.47±13.61), which declined by 29.64% compared to the highest total score (103) in the Chinese version of PANQOLI. Score of physical function, role function, emotional function, and self-worth domain was 25.63±4.84, 13.86±2.78, 16.98±6.21 and 16.00±4.65, respectively. Compared to the highest scores (30, 25, 24 and 24), the scores of aforementioned four domains declined by 14.57%, 44.56%, 29.25% and 33.33%, respectively. Univariate analysis showed that sex, age, employment status, smoking, alcohol consumption, and frequency of pancreatitis recurrence were significantly associated with QoL of CP patients. Multiple linear regression analysis indicated that older age (coefficient=-0.127), unemployment status (coefficient=-0.106), smoking (coefficient=-0.176), and high frequency of pancreatitis recurrence (coefficient=-0.123) were independent factors for QoL of CP patients (all P value <0.05). Conclusions:The Chinese version of PANQOLI could be effectively applied to Chinese CP patients. Older age, unemployment, smoking, and pancreatitis attacks were risk factors for QoL of CP patients, indicating that the formulation of personalized intervention measures may help to improve QoL of CP patients.