Objective To investigate the value of soluble epithelial cadherin(sE-cad)in the differential diagnosis of pleural effusion. Methods Patients were divided into malignant pleural effusion group,infective pleural effusion group and transudation group.sE-cad in pleural fluids obtained during the first thoracocentesis was measured by enzyme-linked immunosorbent assay(ELISA).The concentration of sE-cad in all kinds of pleural effusions was compared.The cut-off value of sE-cad for the differential diagnosis of benign and malignant pleural effusion was determined by ROC curve.The diagnostic value of sE-cad was also compared with common tumor markers such as CEA,CA199,CA125 and NSE.Results The concentration of sE-cad was significant higher in the malignant pleural effusion than in the benign pleural effusion[(38.38?4.15)ng/mL vs(14.17?0.80)ng/mL,P

0.05). Conclusion The exon 8+488C/T polymorphism of Aiolos gene exists in this population of Han ethnics,however,it is not associated with bronchial asthma.

Objective To develop the Chinese version of Attribution Questionnaire-27 and examine its replicability,reliability and validity.Methods The questionnaire was translated using the standard translation/back-translation method and examine its replicability,reliability and validity in 230 medical students who were selected by convenient method.Results The Cronbach α coefficient for Attribution Questionnaire-27 was 0.82 and ranging between 0.55 and 0.84 for the subscales.The test-retest reliabilities of the total scale was 0.77 and the subscales was between 0.61 to 0.81 after one week.Confirmatory factor analysis confirmed the hypothesized six factors attribution of responsibility model (x2/df=3,GFI=0.925,NFI=0.880,CFI=0.856,IFI=0.761,RMSEA=0.094) and three factors dangerous model (x2/df=1.773,GFI=0.959,NFI=0.941,CFI=0.973,IFI=0.973,RMSEA=0.058).The path analysis results support the existing theoretical assumptions.Condusions The Chinese version of Attribution Questionnaire-27 has good reliability and validity and can be used in medical student.

Objective To investigate the status of nurses' resilience and to explore the related factors.Methods 1356 nurses from 11 level Ⅱ and level Ⅲ hospitals of Guangzhou were assessed by using the general information questionnaire and the Chinese version of Conner-Davidson resilience scale.Results The score of nurses' resilience was(59.99±13.59)points and it was significantly lower than that of the domestic norm.There was statistical difference of the score of nurses' resilience on different genders,educational background,professional titles,hospital level and night shifts.There was a positive correlation among educational background,night shifts and nurses' resilience,and a negative correlation between hospital level and nurses' resilience.The hospital level,night shifts and educational background were the influencing factors of nurses' resilience.Conclusions The level of nurses' resilience is low.The higher hospital level and educational background,and the less night shift,the higher of nurses' resilience.

A management window model for patients with atrial fibrillation (AF) was established in Tilanqiao Community Health Service Center cooperated with tertiary hospitals.Patients were screened and treated in the community health service center,and a comprehensive management plan was conducted and patients were followed-up.A total of 105 patients with atrial fibrillation (97.2％) were effectively managed with an average follow-up of 10.6 months.The CHADS2 score ≥ 2 in 78 cases,including 11 cases with administration of warfarin (14.1％) and 26 cases with paroxysmal AF without transition to persistent atrial fibrillation.Compared to the data before management,the rate of taking aspirin and warfarin in managed patients was increased (all P ＜ 0.05),the international normalized ratio (INR) of patients receiving warfarin was improved (P ＜ 0.05) ; the ratio of receiving comprehensive treatment program,standardized treatment and health education were significantly increased (P ＜ 0.05) ; the awareness of the disease,treatment compliance and satisfaction of patients were improved significantly (all P ＜ 0.05).The results suggest that the management widow model is feasible and effective for management of patients with atrial fibrillation in community health service centers.

Objective To discussion the curative effect of improved type of exploring behind burp of suctioning applied in infants' evere pneumonia. Methods Select 60 cases of children used the application ventilator to treat with severe pneumonia, randomly divide into control group of 30 cases and experimental group of 30 cases . The test group was treated improved type with behind burp of suctioning,and the contrast group was treated conventional type with behind burp of suctioning. Compared the changes in PaO2、 PaCO2 and clinical curative effect before and after suctioning. Results There is no significant difference intwo groups of patients before suctioning in PaO2 、PaCO2 (P >0. 05). After suctioning in the test group PaO2 was (51. 31 ± 12. 41 ) , PaCO2 was (48. 98 ± 9. 86). The test group was better than the contrast group in improve the situation in measuring blood gas before and after suctioning . So the test group has more effective than the contrast group. The difference was statistically significant (P < 0. 05). Conclusions using the improved type behind burp of suctioning can significantly reduce the suction of children with severe pneumonia in ventilator time and duration, and increase the cure rate of children with severe pneumonia.

Objective To investigate the changes of C- reactive protein( CRP ) and homocysteine ( Hcy)in the type 2 diabetes with depression,and its clinical significance and potential mechanism. Methods One hundred and twenty-four cases with type 2 diabetes were divided into the depression group(63 cases)and non-depression group( 61 cases ) according to the Self-Rating Depression Scale and verified by Self-Rating Anxiety Scale. The information including age,sex,education degree,body mass index,course of disease and the number of complications were recorded. The levels of CRP,Hcy,fasting plasma glucose( FPG ),glycosylated hemoglobin(HbA1c)and blood lipid were measured. The depression group was divided into mild,medium and heavy group to compared the changes of Hcy and CRP. Results The levels of Hcy,HbA1c and the number of complications in depression group were 11. 5( 8. 6,15. 6 )μmol/L,( 10. 13 ± 2. 17 )%,and 2( 1,3 ) respectively,higher than that of non-depression group(8. 6(7. 4,11. 2)μmol/L,(9. 33 ± 2. 20)%,1(0,2)), while the education degree of depression group((9. 75 ± 3. 36)years)was lower than that of non-depression group((11. 56 ± 3. 73)years),and the differences were significant( t/Z = -3. 537,0. 952,-2. 339,0. 228 respectively;P ﹤0. 05). The levels of Hcy in mild,medium and heavy depression group were(8. 75(7. 45, 10. 45)μmol/L,12. 2(8. 90,14. 40)μmol/L,19. 50(14. 33,28. 03)μmol/L respectively and the difference was significant(F =25. 963,P =0. 000). No significance difference was found in terms of CRP level(2. 35 (1. 10,4. 92)mg/L,3. 25(1. 11,5. 68)mg/L,2. 32(1. 27,5. 41)mg/L;F=0. 194,P=0. 907). There was significant correlation between depression scores and Hcy( r=0. 615,P=0. 000). Conclusion Type 2 diabetes with depression is associated with the level of blood glucose,education degree and the course of disease. Hcy,not CRP is an independent risk factor of type 2 diabetes with depression.

BACKGROUNDLittle quantitative evidence was available regarding the development of NICUs in China. The purpose of this survey was to evaluate the current situation of neurointensive care units (NICUs) across China.

METHODSThe directors of NICUs from 100 tertiary care hospitals across China were contacted and asked to complete a closed response questionnaire regarding their NICUs. Basic information, equipment, and technology information available in the units, as well as staffing information were investigated.

RESULTSSeventy-six questionnaires were returned (a 68% response rate). Of 76 NICUs, 43 units constituted the majority. The number of each NICU bed varied from 4 to 45, occupying 2%-30% of the total department beds. Over 70% of NICUs were equipped with many emergency treatment equipments as well as physiological and biochemical monitoring equipments, while 34%-70% of NICUs still lacked some kinds of equipments such as defibrillators. Some specialist equipments were still partially lacking in 62%-95% of NICUs. A vast majority of the NICUs were equipped with neurocritical care directors, full-time attending physicians, and head nurses, but full-time NICU residents and neurocritical care nurses were still lacking in nearly half (53%) and one-third (33%-37%) of NICUs, respectively. In 76 NICUs, full-time neurointensivists and nurses added up to 359 and 852, respectively. In addition, 78%-97% of all the surveyed NICUs were severely short of non-neurological professional staffs.

CONCLUSIONIn China, neurocritical care has developed rapidly, but there is still a shortage of well-equipped and well-staffed NICUs across the nation currently.

China ; Data Collection ; Humans ; Intensive Care Units ; manpower ; organization & administration ; statistics & numerical data ; Neurology ; Surveys and Questionnaires

BACKGROUNDSeverity scoring systems are useful tools for measuring the severity of the disease and its outcome. This pilot study was to verify and compare the prognostic performance of the Simplified Acute Physiology Score II (SAPS II) and Glasgow Coma Scale (GCS) in neuro-intensive care unit (N-ICU) patients.

METHODSA total of 1684 patients consecutively admitted to the N-ICU at Xuanwu Hospital between January 1, 2005 and December 31, 2011 were enrolled in this study. The data-base included admission data, at 24-, 48-, and 72-hour SAPS II and GCS. Repeated measure data analysis of variance, Logistic regression analysis, the Hosmer-Lemeshow goodness-of-fit statistic, and the area under the receiver operating characteristic were used to evaluate the performance.

RESULTSThere was a significant difference between the SAPS II or GCS score at four time points (F = 16.110, P = 0.000 or F = 8.108, P = 0.000). The SAPS II scores or GCS score at four time points interacted with the outcomes with significant difference (F = 116.771, P = 0.000 or F = 65.316, P = 0.000). Calibration of the SAPS II or GCS score at each time point on all patients was good. The percentage of a risk estimate prediction corresponding to observed mortality was also good. The 72-hour score have the greatest consistency. Discriminations of the SAPS II or GCS score at each time were all satisfactory. The 72-hour score had the greatest discriminative power. The cut-off value was 33 (sensitivity of 85.2% and specificity of 74.3%) and 6 (sensitivity of 70.6% and specificity of 65.0%). The SAPS II at each time point on all patients showed better calibration, consistency and discrimination than GCS. The binary Logistic regression analysis identified physiological variables, GCS, age, and disease category as significant independent risk factors of death. After the two variables including underlying disease and type of admission were excluded, we built the simplified SAPS II model. A correlation was suggested between the simplified SAPS II score at each time point and outcome, regardless of the diagnosis.

CONCLUSIONSThe GCS scoring system tends to be a little weaker in the predictive power than the SAPS II scoring system in this Chinese cohort of N-ICU patients. The advantage of SAPS II scoring system still exists that it dose not need to take into account the diagnosis or diseases categories, even in the special N-ICU. The simplified SAPS II scoring system is considered a new idea for the estimation of effectiveness.

APACHE ; Adult ; Aged ; Aged, 80 and over ; China ; Female ; Glasgow Coma Scale ; Humans ; Intensive Care Units ; statistics & numerical data ; Male ; Middle Aged ; Young Adult

BACKGROUNDThe bacterial composition of periapical lesions in deciduous teeth has not been well documented. This study was designed to explore the bacterial compositions, especially the dominant bacteria in periapical lesions using 16S rRNA sequencing.

METHODSTissue samples were collected from 11 periapical lesions in deciduous teeth with primary endodontic infections. DNA was extracted from each sample and analyzed using 16S rRNA cloning and sequencing for the identification of bacteria.

RESULTSAll DNA samples were positive for 16S rRNA gene PCR. One hundred and fifty-one phylotypes from 810 clones were identified to eight phyla, and each sample contained an average of 25.9 phylotypes. In addition, 59 phylotypes were detected in more than two samples, and Fusobacterium (F.) nucleatum (8/11), Dialister (D.) invisus (8/11), Campylobacter (C.) gracilis (7/11), Escherichia (E.) coli DH1 (6/11), Aggregatibacter (A.) segnis (6/11), and Streptococcus (S.) mitis (6/11) were the most prevalent species. Furthermore, 45 as-yet-uncultivated phylotypes were also identified.

CONCLUSIONSChronic periapical lesions in deciduous teeth contained polymicrobial infections. F. nucleatum, D. invisus, C. gracilis, E. coli DH1, A. segnis, and S. mitis were the most prevalent species detected by 16S rRNA sequencing.

Bacteria ; classification ; genetics ; isolation & purification ; Bacterial Infections ; microbiology ; Child ; Child, Preschool ; Female ; Humans ; Male ; Periapical Tissue ; microbiology ; RNA, Ribosomal, 16S ; genetics ; Tooth, Deciduous ; microbiology