Third party custody system at the Second Affiliated Hospital ot Zhejiang University has reduced hospital costs,raised efficiency and optimized resources.The standardized management system featuring 5S+ 1 achieved such outcomes as +5 and -5,and 0 inventory.A three-year review of the economic performance at the hospital has saved three million yuan of costs,proving that the system can help build an effective material supply system for contemporary general hospitals.

Objective:To investigate the clinical value of modified acute aortic dissection risk score in the early diagnosis of acute aortic dissection (AAD).Methods:The general, clinical, and imaging data of 162 patients who complained of chest and back pain who received treatment between January 2019 and January 2021 in the Department of Emergency, The Second Hospital of Jiaxing, China were collected for this study. The included patients were divided into control (non-AAD, n = 120) and observation (AAD, n = 42) groups according to whether they were diagnosed with AAD. The indexes with statistical significance between the two groups were analyzed using multivariate logistic regression analysis. A score table was established according to the size of OR value. The modified AAD risk score was predicted using the receiver operating curve. Results:Multivariate logistic regression analysis showed that male sex, family history, sudden severe chest and back pain, bilateral blood pressure asymmetry, hypertension, abnormal ultrasound, and D-dimer level were independent risk factors for the diagnosis of AAD (statistical values = 7.84, 6.96, 7.04, 11.38, 7.12, 8.15, 15.07, 9.11, all P < 0.05). Taking the total score of 5 as the prediction standard, the specificity and sensitivity in the prediction of the occurrence of AAD were 84.94% and 95.43%, respectively. The area under the receiver operating curve regarding the modified AAD risk score was 0.909. Conclusion:The modified AAD risk score can be used to conveniently and quickly predict the occurrence of AAD and has a high predictive value. This study is highly innovative and scientific.

Objective To investigate the appropriate age of primary and secondary school students for cardiopulmonary resuscitation (CPR) training.Methods A total of 437 students aged 9-15 years at 3 to 6 grade in the primary schools or 1 to 2 grade in the secondary schools were selected from 2 Yuyao primary and secondary schools by stratified random sampling between March 2017 and January 2018.The numbers of students with the age of 9,10,11,12,13,14 and 15 y were 61,62,66,64,63,63 and 58,respectively.All students received chest compression training provided by Yuyao emergency department People's Hospital according to the 2015 Cardiopulmonary Resuscitation Guidelines.The training included 30 min theoretic teaching and 6 min practice in the simulator.The quality of chest compression performed by students was assessed;the depth,rate,position and retention of chest compression were recorded.Results The mean depth of chest compression in the students aged 9-15 years was 3.8,4.1,4.6,5.1,5.2,5.6 and 5.6 cm,respectively;the accuracy rate was 24.6％(14/61),25.8％ (16/62),50.2％ (33/66),70.5％ (45/64),79.4％(50/63),88.9％(56/63) and 91.4(53/58),respectively.Compared with the students aged 9-11 years,the mean depth of chest compression was significantly increased and accuracy rate was significantly improved in the students aged 12-15 years (Compared with 9-y students,t=-8.936,-9.502,-10.640 and-11.370;x2=35.019,47.599,63.013 and 65.671;compared with 10-y students,t=-6.927,-8.179,-10.70 and-11.047;x2=24.977,35.967,50.916 and 52.727;compared with 1 1-y students,t=-3.095,-4.177,-6.785 and-6.995;x2=5.586,12.114,22.786 and 24.870;all P＜0.05).The mean rate of chest compression was 110-116/min and its accuracy rate was 86.4％-95.2％;the accuracy rate of chest compression position was 90.9％-96.8％ in all students,there were no significant differences among the 7 groups.The mean retention rate of chest compression in the 7 groups was 81.3％(122/150),67.3％(101/150),64.7％ (94/150),48.0％(72/150),48.7％(73/150),33.3％(50/150) and 27.3％(41/150),respectively.Compared with the students aged 9-11 years,the mean retention rate of chest compression was significantly decreased in the students aged 12-15 years (compared with the 9-y students,x2=36.472,35.179,70.64 and 119.92;compared with 10-y students,x2=11.483,10.728,34.682 and 72.150;compared with 11-y students,x2=6.528,5.927,25.855 and 59.11;all P＜0.05).Correlation analysis showed that the depth (r=0.96,0.89,0.91 and 0.86;P＜0.01) and retention rate (r=-0.99,-0.90,-0.93 and-0.86;all P＜0.01) of chest compression were significantly associated with the age,body weight,height and body mass index of students.Conclusion The students with an age of 12 years or more are able to effectively perform chest compression;thus,12 years and above might be the appropriate age for CPR training.

Objective This study was to understand the status of pollution on drinking water, by volatile organic compounds(VOCs),among rural residents living in the basin of Huaihe River. Relationship between the morbidity,morbidity of cancers and VOCs were also explored. Methods 28 villages were chosen from Xuyi,Jinhu,Chuzhou along the Huaihe River,with water samples collected from ditch pond water,shallow wells,deep wells in November-December 2010. VOCs indicators were evaluated according to the Standard Quality GB 5749-2006 for Drinking Water. Results Methylene chloride,chloroform,benzene and carbon tetrachloride were all detected in 76 water samples. The rates of chloroform,benzene,carbon tetrachloride which exceeding the quality standards were 3.95%,21.05% and 22.37%,but no significant differences were found among these three water resources in chloroform,benzene or carbon tetrachloride. Results from the correlation analysis showed that benzene had positive correlation with tumor deaths(r=0.24,P<0.05). Results from the risk assessment on health showed that some chloroform,benzene,carbon tetrachloride products which were related to the risks of cancers were exceeding the acceptable ranges of risk,with the rates as 28.95%,22.37% and 64.47% but with no significant differences among the three water resources(P>0.05). Conclusion Drinking waters for rural residents along the Huaihe River were polluted while VOCs might have related to tumor incidence with potential impact and risk to the health of local residents.

Objective:To integrate the best evidence of non-drug intervention of urinary incontinence in elderly women and to formulate practical recommendations.Methods:In this systematic review study, using “elderly woman”,“urinary incontinence”,“bladder training”,“pelvic floor muscle training”,“enuresis”,“leakage of urine” as the key words, the 6S evidence resource pyramid model was used to search in British Medical Journal best practice, Uptodate, World Health Organization, Guidelines International Network, National Institute for Health and Care Excellence, Chinese Medical Association, Scottish Intercollegiate Guideline Network, Registered Nurses Association of Ontario, Cochrane Library, The Joanna Briggs Institute (JBI), New Zealand Guidelines Group, Polish Society of Gynecologists and Obstetricians, PubMed, Embase, Medline, Web of Science, SinoMed, China National Knowledge Infrastructure, WanFang Data, etc. The evidence retrieved included evidence-based knowledge base resources, clinical practice guidelines, expert consensus, systematic review, etc. Data were retrieved from January 1, 2017 to May 1, 2022, and collated from May 2, 2022 to May 25, 2022. Two researchers independently evaluated the quality of literature and extracted data using the AGREE Ⅱ and JBI evidence-based health care center assessment tools. The JBI evidence-based health care center′s evidence pre-rating system and evidence recommendation rating system were applied to rank the evidence; and under the guidance of the evidence structure of JBI, the strength of evidence recommendation was determined and the best evidence was extracted and summarized in combination with the study group discussion and expert opinion.Results:A total of 9 articles were retrieved, including 7 guidelines and 2 systematic reviews; and 6 guidelines were classified as Grade A and 1 as grade B; both 2 systematic reviews were rated as Grade A; 84% (27/32) of the items were evaluated as “Yes”. Evidence were summarized as 34 pieces of best evidence from 6 dimensions, including “overall recommendation, evaluation of type and degree of urinary incontinence, lifestyle change, behavioral therapy, prevention of precipitating factors, intervention in special population”; the flow chart of screening, evaluation, special symptoms, life style and behavior therapy was combed, and the practical suggestions were formed.Conclusions:The overall quality of the literature on non-drug intervention of urinary incontinence in elderly women is high, and the level of evidence is high. Early identification of urinary incontinence types and assessment of disease severity, lifestyle changes, avoidance of predisposing factors and behavioral therapy are the key to non-drug treatment of urinary incontinence in those patients.

Objective To delve into the causal relationship between 211 gut microbiota and sepsis employing bidirectional Mendelian randomization(MR).Methods The gut microbiota genome-wide association study(GWAS)data from the Microbiome Genetics Consortium(MiBioGen,n = 18 340)and sepsis GWAS data from the FinnGen(n = 286 146)were harnessed for this study.Initially,single nucleotide polymorphisms(SNP)significantly associated with the relative abundance of 211 gut microbiota taxa were identified as instrumental variables using predefined selection criteria.The primary analytical approach was characterized by the application of inverse variance weighting(IVW),with the effect measure represented by the odds ratio(OR)to assess the results of MR.To ensure precision and reliability,analyses were conducted,including leave-one-out analysis,heterogeneity testing,and tests for pleiotropy at both coherent and incoherent levels.Results The increased risk of sepsis was associated with the elevated abundance of Collinsella[OR = 1.28,95%confidence interval(95%CI)was 1.06-1.56,P = 0.01]and Ruminococcus(OR = 1.19,95%CI was 1.05-1.35,P = 0.005).Furthermore,a protective effect against the development of sepsis was observed in association with the increased abundance of Prevotella(OR = 0.88,95%CI was 0.79-0.97,P = 0.01)and Firmicutes(OR = 0.86,95%CI was 0.75-0.996,P = 0.04).No obvious heterogeneity and irrelevant level pleiotropy were detected.Conclusion Collinsella and Ruminococcus increase the risk of sepsis,while Prevotella and Firmicutes have protective effects against sepsis.

OBJECTIVEThis study was to understand the status of pollution on drinking water, by volatile organic compounds (VOCs), among rural residents living in the basin of Huaihe River. Relationship between the morbidity, morbidity of cancers and VOCs were also explored.

METHODS28 villages were chosen from Xuyi,Jinhu, Chuzhou along the Huaihe River, with water samples collected from ditch pond water, shallow wells, deep wells in November-December 2010. VOCs indicators were evaluated according to the Standard Quality GB 5749-2006 for Drinking Water.

RESULTSMethylene chloride, chloroform, benzene and carbon tetrachloride were all detected in 76 water samples. The rates of chloroform, benzene, carbon tetrachloride which exceeding the quality standards were 3.95% , 21.05% and 22.37% , but no significant differences were found among these three water resources in chloroform, benzene or carbon tetrachloride. Results from the correlation analysis showed that benzene had positive correlation with tumor deaths (r = 0.24, P < 0.05). Results from the risk assessment on health showed that some chloroform, benzene, carbon tetrachloride products which were related to the risks of cancers were exceeding the acceptable ranges of risk, with the rates as 28.95%, 22.37% and 64.47% but with no significant differences among the three water resources (P > 0.05).

CONCLUSIONDrinking waters for rural residents along the Huaihe River were polluted while VOCs might have related to tumor incidence with potential impact and risk to the health of local residents.

China ; Drinking Water ; chemistry ; Humans ; Risk Assessment ; Rural Health ; statistics & numerical data ; Volatile Organic Compounds ; adverse effects ; analysis ; Water Pollution, Chemical ; adverse effects ; analysis

OBJECTIVETo investigate the association of neuroendocrine differentiation with progression and prognosis of gastric adenocarcinoma.

METHODSClinicopathological data of 240 patients with gastric adenocarcinomas were retrospectively analyzed. The expression of chromogranin A, synaptophysin and secrectagogin in cancer tissue was assessed by immunohistochemistry. The association of neuoroendocrine differentiation parameters with disease progression and survival of patients was analyzed.

RESULTSThe expression of synaptophysin was positively correlated with depth of invasion and secretagogin more often expressed in cases with lymph node metastasis. In Lauren diffuse type of cancer, expression of chromogranin A and secretagogin was unfavorable prognostic predictor. In TNM stage II adenocarcinoma, expression of chromogranin A and synaptophysin related to poor survival, and multivariate Cox proportional hazard model showed that synaptophysin was an independent predictor for poor survival.

CONCLUSIONNeuroendocrine differentiation predicts deeper depth of invasion, more possibility of lymph node metastasis and poor survival in gastric adenocarcinoma.

Adenocarcinoma ; diagnosis ; pathology ; Biomarkers, Tumor ; metabolism ; Chromogranin A ; metabolism ; Disease Progression ; Humans ; Immunohistochemistry ; Lymphatic Metastasis ; Neoplasm Staging ; Neuroendocrine Tumors ; diagnosis ; pathology ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Secretagogins ; metabolism ; Stomach Neoplasms ; diagnosis ; pathology ; Synaptophysin ; metabolism