Objective:To study the mental state of primigravida before delivery and the effect of psychological help on their mood and delivery type.Method:272 primigravida who was just near their delivery were assessed with STAI and VAS for anxiety in Labor, 152 of them received psychological help including support from medical staff and family members in a sweet environment with accompanied family members?The other 120 primigravida received routine labor service.Result:During labor, primigravida had bad mood,psychological help deceased their anxiety and fear, and was helpful in upgrading the rate of delivery.Conclusion:Bad mood of primigravida is common, supportive attitude and environment are helpful to both mental state and their delivery.

Objective To explore the associated risk factors on patients with organophosphorus poisoning combine with respiratory failure secondary pulmonary infection.Methods Two hundred and twenty-four clinical data of organophosphorus poisoning combine with respiratory failure were collected from January 2009 to May 2013.Retrospectively analyzed the situation of pulmonary infection and Logistic regression model were used to analyzed the relative risk of organophosphorus poisoning combine with respiratory failure secondary pulmonary infection.Results The secondary pulmonary infection rate of organophosphorus poisoning combine with respiratory failure was 68.75％ (154/224).Logistic regression analysis showed that combined with aspiration,hand hygiene,breathing machine,the decrease of cholinesterase activity were the relative risk factors (P ＜ 0.05).Conclusions The secondary pulmonary infection rate of organophosphorus poisoning combine with respiratory failure is higher.Combined with aspiration,hand hygiene,breathing machine,the decrease of cholinesterase activity may be the relative risk factors.

Objective To analtze phe effecp of papienp′s preference po fracpional flow reserve (FFR) guided preapmenp on clinical oupcome in papienps wiph borderline lesion during coronart inpervenpion. Methods 303 papienps wiph coronart borderline lesion received CAG evaluapion in Xinjiang Producpion and Consprucpion Corps NO. 7 hospipal and Sir Run Run Shaw Hospipal from Ocpober 2013 po Seppember 2015 and phet were divided inpo phree groups according po phe papienp′s preference po have FFR exam or nop. The 3 groups were: ①FFR Guided PCI group (n = 96, papienps wiph FFR≤0. 8 accepp PCI, whereas onlt drug preapmenp if FFR > 0. 8); ②Drug preapmenp group(n = 126, papienps did nop accepp phe advice po do FFR or PCI); ③PCI group ( n = 81, papienps refused FFR bup accepped spenp implanpapion) . The papienps were followed up for (19. 6 ± 6. 5) monphs afper preapmenp. Rapes of major adverse cardiac evenps(MACE) and recurrence of angina pecporis were recorded and compared. Results Angina remission rape in phe FFR guided PCI group was higher significanplt phan drug preapmenp group and PCI group (85. 4% vs. 69. 8% vs. 80. 2% , P =0. 018). MACE-free survival rape of FFR guided PCI group was higher(93. 8% vs. 77. 0% vs. 81. 5% , P =0. 006)phan phe opher 2 groups. Conclusions FFR guided preapmenp provides beneficial effecps po phe oupcomes of borderline lesion. Bup in phe real world, papienp′s preference mat plat a decisive role.

Objective:To explore the predictive value of MB isoenzyme of creatine kinase (CK-MB) and poisoning severity score (PSS) in the clinical prognosis of patients with wasp sting.Methods:A retrospective study was conducted. The clinical data of patients who were stung by wasps admitted to emergency department of the First Affiliated Hospital of Henan University of Science and Technology from July 2017 to November 2019 were collected. The 24-hour acute physiology and chronic health evaluation Ⅱ (APACHEⅡ), CK-MB and PSS scores of the patients were collected after admission, and 28-day outcome was recorded. Spearman correlation analysis method was used to analyze the correlation between CK-MB and PSS score. Logistic regression model was used to construct joint predictors, and the receiver operating characteristic (ROC) curve was drawn to evaluate the predictive value of various indicators for 28-day prognosis of patients with wasp stings.Results:Finally 90 patients were included in the analysis. There were 67 patients survived at 28 days, and 23 dead with the 28-day mortality of 25.6%. APACHEⅡ score, CK-MB and PSS score in the death group were significantly higher than those in the survival group [APACHEⅡscore: 19.7±2.7 vs. 13.7±2.3, CK-MB (U/L): 183 (151, 243) vs. 36 (21, 75), PSS score: 17.7±2.6 vs. 9.3±4.5, all P < 0.01]. The correlation analysis showed that CK-MB and PSS score were positively correlated ( r = 0.843, P < 0.01). Logistic regression model fitted CK-MB and PSS score, and Hosmer-Lemeshow test showed that the model fitted well. ROC curve analysis showed that the area under ROC curve (AUC) of CK-MB for predicting 28-day outcome was 0.957, the sensitivity was 91.3%, and the specificity was 88.1%; the AUC of PSS score was 0.908, the sensitivity was 91.3%, and the specificity was 90.8%. The AUC of CK-MB combined with PSS score was 0.964, the sensitivity was 100%, and the specificity was 79.4%, indicating that CK-MB combined with PSS score had higher predictive value and higher sensitivity for 28-day prognosis of patients with wasp sting. Conclusions:High CK-MB level and high PSS score in early stage of wasp sting injury indicate poor prognosis. Both CK-MB and PSS score can be used as predictors for predicting the prognosis of patients with wasp stings. In addition, CK-MB combined with PSS score have greater predictive value .

Objective To compare intravascular ultrasound (IVUS) and coronary angiography in measuring the lumen diameter and coronary arteries stenosis rate, to investigate the impact of IVUS in the choice of surgical indications, surgical procedure guidance and effects of operation.Methods The patients who underwent percutaneous coronary intervention(PCI) therapy from may 2013 to may 2014 were divided into IVUS-guided intervention therapy group (n=89) and coronary angiographyguided group (n=90).Their baseline parameters, lesion features, MACE and restenosis during follow-up were analyzed.Results Baseline clinical and angiographic characterisitcs were well matched and show no significant differences between the two groups.Compared to angiography-guided group, the minimum lumen diameter (MLD) of IVUS-guided group were higher, diameter stenosis (DS) and lesion length (LL) were lower in IVUS-guided intervention therapy group.The detection rate of calcified and eccentric lesion were significantly higher in IVUS-guided group.There were 204 (93.6 ％) and 195 (87.8％) high-pressure balloons used in post-inflation in two groups, respectively.The MLD and plaque burden of IVUS-guided group were obviously improved after stent implantation.Conclusions IVUS-guided intervention therapy in PCI is safe and effective, may be helpful for the judgment of lesion, evaluating stent implantation and guiding high-pressure balloon post-inflation.IVUS-guided intervention could get the bigger immediate lumen diameter and lower plaque burden than coronary angiography without serious short-term or long-term complications.

Objective To investigate the pathogens,drug resistance and outcomes of continuous ambulatory peritoneal dialysis(CAPD) patients with peritoneal dialysis-related peritonitis in our peritoneal dialysis(PD) centers. Method Data including clinical manifestations,pathogens,treatment,outcome of 93 CAPD cases with peritoneal dialysis-related peritonitis in our peritoneal dialysis(PD) centers were retrospectively analyzed.Results Dialysate culture of 75cases was positive with a positive rate of 80.2％,including 45 cases of gram-positive cocci,21cases of gram-negative bacilli,2 cases of fungi and 5 cases of mixed infection.Coagulase-negative staphylococci were the most common gram-positive cocci.All the gram-positive cocci were sensitive to vancomycin,but the resistance rate to cefazolin was 60.0％ with an increasing tendence year by year.Resistance rate of gram-negative bacilli to ceftazidime was 46.1％.All the gram-negative bacilli were sensitive to imipenem.The withdraw rate of CAPD was 17.2％(16/93) because of peritonitis. Noobviousside-effectofperitonealadministrationofvancomycinwasfound.Conclusions Gram-positive cocci are major pathogens in CAPD-related peritonitis.Now cefasolin is not suitable for the empiric initial treatment.Peritoneal administration of vancomycin should be recommended for peritonitis caused by gram-positive cocci.

Objective To systematically evaluate the diagnostic accuracy and clinical applicability of recognition of stroke in the emergency room (ROSIER) scale by systematic review and Meta-analysis. Methods The Chinese and English literatures concerning the diagnostic accuracy of ROSIER published from January 1st 2005 to December 31st 2018 by PubMed, Embase, Wanfang, VIP and CNKI databases were searched comprehensively and systematically. The sensitivity, specificity, and diagnostic odds ratio (DOR) of ROSIER in total population and subgroup analysis were pooled by using bivariate mixed effects model. Sensitivity analysis was used to evaluate the stability of the results. Deek funnel plot was utilized to evaluate publication bias. The clinical applicability of ROSIER was evaluated by Fagan Nomogram. Results A total of 28 studies incorporating 7 579 subjects were enrolled in this Meta-analysis. Meta-analysis in total population showed that the pooled sensitivity, specificity and DOR of ROSIER was 0.89 [95% confidence interval (95%CI) = 0.86-0.91, P = 0.00], 0.74 (95%CI = 0.67-0.80, P = 0.00) and 22.09 (95%CI =14.86-32.82, P = 0.00), respectively. Subgroup analysis of pooled sensitivity of ROSIER showed that Asian patients was significantly higher than European patients [0.89 (95%CI = 0.86-0.92) vs. 0.74 (95%CI = 0.66-0.82), P < 0.01], prospective study was significantly higher than retrospective study [0.89 (95%CI = 0.87-0.92) vs. 0.74 (95%CI = 0.61-0.88), P < 0.05], pre-hospital emergency was significantly higher than emergency department [0.87 (95%CI = 0.80-0.94) vs. 0.85 (95%CI = 0.81-0.90), P < 0.01], study with sample size ≤ 200 was significantly higher than study with sample size > 200 [0.88 (95%CI = 0.83-0.93) vs. 0.82 (95%CI = 0.76-0.88), P < 0.05], but there was no significant difference between different evaluators or different male to female ratio subgroups. Subgroup analysis of pooled specificity of ROSIER showed that European patients was significantly higher than Asian patients [0.81 (95%CI = 0.73-0.89) vs. 0.79 (95%CI = 0.73-0.85), P < 0.05], retrospective study was significantly higher than prospective study [0.88 (95%CI =0.78-0.97) vs. 0.79 (95%CI = 0.73-0.84), P < 0.05], pre-hospital emergency was significantly higher than emergency department [0.82 (95%CI = 0.73-0.91) vs. 0.79 (95%CI = 0.73-0.85), P < 0.01], emergency physicians was significantly higher than other medical workers [0.80 (95%CI = 0.74-0.86) vs. 0.79 (95%CI = 0.69-0.90), P < 0.05], study with sample size ≤ 200 was significantly higher than study with sample size > 200 [0.82 (95%CI = 0.76-0.89) vs. 0.78 (95%CI = 0.71-0.85), P < 0.05], but there was no significant difference between different male or female ratio subgroups. Sensitivity analysis showed that there was no significant change in pooled DOR before and after excluding each study, indicating that the results were stable. Funnel plot showed that there was a significant publication bias in the total population (P = 0.04), but there was no publication bias in the European population (P = 0.57) or the Asian population (P = 0.08). According to the results of the Fagan Nomogram, with the pretest probability of 50%, when ROSIER was positive, the probability of being diagnosed with stroke increased to 77%, and when ROSIER was negative, the probability of being diagnosed with non-stroke decreased to 13%. It was suggested that ROSIER had good applicability and high clinical diagnostic value. Conclusions ROSIER has high diagnostic sensitivity and specificity, and has high clinical diagnostic value. It is a valid stroke identification tool which can be widely used in Asian population, pre-hospital emergency and be utilized by trained medical worker.

To evaluate the prognostic value of early white blood cell count (WBC) in patient of acute paraquat poisoning. Methods The literatures about the studies on early WBC and prognosis after paraquat poisoning published in journals at home and abroad were searched. The Chinese literature database contained CNKI, VIP, Wanfang Database, and China Biomedicine Database (CBM), and the journals were limited to the core journals. The foreign language database included PubMed, Embase and Cochrane library clinical controlled trial database. The retrieval date was from the initial publication to April 22nd in 2019, without the limitation of languages. Two researchers independently extracted literature information, and the Newcastle-Ottawa Scale (NOS) was used to evaluate literature quality. The odds ratio (OR), sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR) and the area under the summary receiver operating characteristic (SROC) were combined and analyzed through the Stata 15.0 software to evaluate the predictive value of early WBC after acute paraquat poisoning. Publication bias was analyzed by Deeks funnel graph. Results There were 7 retrospective studies and 1 prospective study in a total of 980 paraquat poisoning patients, 5 of them were English literatures, the others were Chinese literatures. There was no heterogeneity among the studies (I 2 = 43.5%, P > 0.05). The OR and its 95% confidence interval (95%CI) of the literature was combined through the fixed effect model. The Meta-analysis results were statistically significant (OR = 18.63, 95%CI = 13.63-25.48, P < 0.001), suggesting that the WBC was significantly correlated with the mortality of patients. The combined sensitivity, specificity, PLR, NLR and DOR were 0.75 (95%CI = 0.66-0.82), 0.85 (95%CI = 0.80-0.90), 5.14 (95%CI = 3.86-6.86), 0.29 (95%CI = 0.22-0.39), 17.53 (95%CI = 12.23-25.13) respectively, and the area under the SROC of the WBC was 0.88 (95%CI = 0.85-0.91). Deeks funnel plot was symmetrical (P = 0.21), and there was no obvious publication bias. Conclusion The early WBC has a certain predictive value for the prognosis of acute paraquat poisoning patients.

Objective To investigate the protective effect of complement 5a receptor 1 (C5aR1) antagonist on ascending urinary tract infection in mice.Methods (1) Female C57BL/6 mice were randomly divided into experimental and control groups:38 mice in each group,and inoculated with E.coli by urethral catheterization to set up the ascending urinary tract infection model.C5aR1 antagonist (W54011 or PMX53) and corresponding control (PBS or control peptide) were initially given either at 2 h before or 3 h after infection by intraperitoneal injection.Mice were sacrificed to assess the infection in bladder and kidney at 24 or 48 h after infection.The bacterial load of bladder and kidney tissue was measured by agar plate assay.The mRNA expression of renal inflammatory factors was detected by real-time RCR.The renal tissue injury and inflammatory cell infiltration were assessed by HE staining and pathological scores.(2) Primary cultured renal tubular epithelial cells were randomly divided into antagonist and control groups to detect and compare the bacterial adhesion to renal tubular epithelial cells in vitro.Results Compared with control groups,the initial delivery of C5aR1 antagonist (W54011 or PMX53) before E.coli inoculation reduced the bacterial load in bladder and kidney tissue 48 h after infection (all P ＜ 0.01).In experimental group given W54011 before infection,the renal pathological scores were reduced (both P ＜ 0.05),as well as renal inflammatory factor expressions:CXCL-1 mRNA,IL-6 mRNA and TNF-o mRNA (all P ＜ 0.05).Compared with corresponding control groups,the initial delivery of PMX53 after E.coli inoculation could also reduce the bacterial load in bladder and kidney tissue 48 h after infection (both P ＜ 0.01).Furthermore,C5aR1 antagonists W54011 and PMX53 could decrease bacteria adhesion to renal tubular epithelial cells in vitro,compared with control groups (both P ＜ 0.05).Conclusions C5aR1 antagonists can significantly attenuate renal tissue injury,ameliorate renal inflammation and the adhesion of bacteria to renal epithelial cells.C5aR1 may be an effective target for the prevention and treatment of urinary tract infection.

Objective To evaluate the effect of levosimendan on prognosis and circulation disorders of sepsis patients. Methods With the guidance of these following Chinese or English key words, such as sepsis, severe sepsis, septic shock, simendan, levosimendan, etc., some of Chinese and foreign published literatures on randomized controlled trials (RCTs) concerning the effects of levosimendan on the prognosis and circulatory function of septic patients were searched through China National Knowledge Infrastructure (CNKI) internet, VIP and Wanfang Databases, China Biomedicine Database (CMB), Pubmed in American National library, Holland Medical Abstract Database (Embase), Cochrane Library, etc databases, from the creation of above various databases to May 2017. The quality of the collected RCTs was evaluated by modified Jadad score; Revman 5.3 software was used to carry out Meta analysis; the publication bias was assessed by the funnel plots. Results A total of 18 RCTs, 9 in Chinese and 9 in English, but only half of the literatures were of high quality, and the other 9 of low quality, containing 688 cases in control group and 704 cases in experimental group were ultimately enrolled in this analysis. The Meta analyses showed that there was no statistical significant difference in the mortality between the experimental group and the control group [relative risk (RR) = 0.92, 95% confidence interval (95%CI) = 0.80 - 1.06, P = 0.27]; compared with control group, the time of stay in ICU was shortened [mean difference (MD) = -2.02, 95%CI = -2.90 to -1.13, P < 0.000 01], cardic output index was increased (MD = 0.63, 95%CI = 0.39 - 0.87, P < 0.000 01), and blood lactate level was decreased (MD = -1.37, 95%CI = -1.51 to-1.23, P < 0.000 01) in the experimental group, being significantly improved after levosimendan therapy. The funnel map evaluation showed that there might be a certain bias in the publication of the literature. Conclusion Levosimendan can improve circulatory disorders and reduce the time of stay in ICU for septic patients, but can not reduce their mortality.