ABSTRACT:Objective To compare the prognostic value of cystatin-C (Cys-C)and creatinine (Cr)in chronic heart failure (CHF)in old people.Methods We recruited 183 old patients (>75 years)diagnosed with CHF hospitalized at the Department of Cardiology and the Department of Geriatrics of our hospital from 2010 to 2012. Venous blood was withdrawn to detect the expressions of Cys-C and Cr.After three-year follow-up,the patients’ three-year survival was recorded.Logistic regression model was used to examine the relationship of Cys-C,Cr and other risk factors with the CHF patients’mortality.ROC curve was used to compare the prognostic value of Cys-C and Cr in CHF in old people and statistical method was adopted to analyze the combined use of Cys-C and Cr for determining their value in evaluating CHF prognosis.Results At the end of the follow-up,74 (40.44%)patients died.Serum cys-C and Cr levels of the patients in death group increased compared with those in survival group (P<0.05).Multivariate logistic regression showed that age (OR=1.11,95% CI=1.04-1.19),SBP (OR=1.06,95%CI=1.01-1.10),LVEF (OR=0.89,95% CI=0.82-0.95),BNP (OR=4.74,95% CI=1.77-12.69), creatinine (OR=2.04,95% CI=1.03-4.08),and Cys-C (OR=2.97,95% CI=1.44-6.12)were the independent risk factors for the prognosis of CHF.ROC analysis showed that Cys-C was superior to creatinine in AUC value (0.71 vs.0.65;95% CI,0.64-0.78;95% CI,0.58-0.72)(P<0.001).The AUC value of Cys-C and Cr in combination was 0.73 (95% CI,0.66-0.79).Conclusion Cys-C is a stronger predictor of the prognosis of CHF patients than creatinine and the combination of the two can increase the sensitivity and specificity in evaluating the prognosis of patients with CHF.

Objective To analysis the clinical feaures and risk factors of recurrent intracerebral hemorrhage(ICH). Methods Analysis clinical data of 68 recurrent ICH patients and compared with those of patients with first-ever ICH. Results 43 recurrences were seen in 38 patients.The mean interval between 2 episodes was(3.9?2.8)years.The most common type of recurrence was"ganglionic-ganglionic",next was"ganglionic-thalamic",and"ganglionic-lo- bar"seldom.Most recurrences occurred contrala-terally and seldom at the same site as the first episode.In contrast to those with first-ever ICH,patients with recurrent ICH most have a hypertension and course of longer,all with a poor control.Analysis showed that the hypertension course was positively and the age of the first hemorrhage was negatively associated with the recurrence of ICH.Conclusion The risk of recurrence of ICH is relatively high within the first 4 years after the previous hemorrhage.Positively control hypertension to normal level,It will have impartant meaning to prevent occurrence of recurrent ICH.

Objective To develop a satisfactory and reliable method for simultaneous determination of seven cephalosporin antibiotics (cefadroxil,cephalexin,cefoperazone,cefuroxime,cefradine,ceftazidime and cefotaxime) in water samples using solidphase extraction and high performance liquid chromatography.Methods The detection and reference wavelengths were 254 and 270 nm,respectively.The analytes were separated within 20 min by a gradient elution program.The optimized pretreatment of water samples was as following:using hydrophilic-lipophilic balance HLB as SPE cartridges,adjusting pH to 3 and adding 3.0 g NaCl per 500 ml water sample.Results The linear range of the method was 0.05-5.00 mg/L for ceftazidime,cefotaxime and cefuroxime,0.10-10.00 mg/L for cefadroxil,cephalexin and cefradine,and 0.20-20.00mg/L for cefoperazone.The coefficients for the analytes were above 0.99 and the limits of determination were 0.05-0.39 ?g/L.The recoveries of seven cephalosporin antibiotics in purified water were 86.64%-105.28%,and its relative standard deviation were 2.61%-11.64%.Conclusion The method was sensitive,accurate and repeatable,it is applicable to the determination of the cephalosporin antibiotics in waters.

Objective:To investigate the effect of Caprini risk score-based care on the prevention of venous thromboembolism of patients with major orthopedic surgery.Methods:Totally 124 patients with major orthopedic surgery were randomly divided into experimental group and control group, each group contained 62 cases. The control group received routine thrombosis prevention nursing, patients in the experimental group carried out Caprini risk score-based intervention. The rate of VTE was compared between two groups, the levels of D-Dimer as well as thigh circumference was measured after 24 hours of admission, 3 days after surgery, 5 days after surgery and at discharge day. At discharge day, the inpatients satisfaction with nursing service scale was used to assessment the satisfaction with nursing service of inpatients.Results:The rate of VTE in the experimental group was 1.6% (1/62) and 6.5% (4/62) in the control group, the difference was not statistically significant ( χ2 value was 1.876, P=0.171). Three days after surgery, 5 days after surgery and at discharge day, the D-Dimer were (1.26±0.65) μg/ml, (1.27±0.35) μg/ml, (0.96±0.27) μg/ml in the experimental group, 5 days after surgery and at discharge day, the thigh circumference were (29.81±4.15) cm, (28.86±3.40) cm in the experimental group, significantly lower than those in the control group [(1.64±0.58) μg/ml, (1.51±0.55) μg/ml, (1.25±0.44) μg/ml, (31.84±5.22) cm, (30.83±3.91) cm], the difference was statistically significant ( t value was 2.405-4.485, P<0.05). The health education and guidance, personality traits, service quality, discharge guidance scores and total satisfaction scores were 26.31±3.06, 35.73±3.64, 27.89±3.11, 8.47±1.18 and 111.08±6.33, significantly higher than those in the control group (24.15±2.31, 33.92±2.66, 26.27±3.41, 7.42±1.82 and 106.52±5.85), the difference was statistically significant ( t value was 2.750-4.433, P<0.05). Conclusions:Caprini risk score-based nursing care significantly alleviates the hypercoagulable states and relieves the degree of swelling of the affected of patients with major orthopedic surgery, as well as improves patients' satisfaction with nursing work.

Objectives To study two airway humidification methods on airway humidification of tracheotomy patients. Methods Sixty patients with traeheotomy were evenly randomized into experiment group and control group:in the former,the method of continuous oxygen atomization was used and in the latter,that of intermittent intratracheal instillation was used.The effects were compared in terms of stimulating cough,sputum clot formation,frequency of suction phlegm,time spent on the airway humidification and incidence of pulmonary infection between the groups.Results The effects in the experiment group were significantly better than in the control group in terms of stimulating cough,sputum clot formation,frequency of suction phlegm,time spent on the airway humidification and incidence of pulmonary infection(all P<0.05).Conclusion Continuous oxygen atomization can improve the effects of airway humidification,reduce the incidence of pulmonary infection and improve the efficiency of nursing work.

Objective To evaluate the effect of Saccharomyces boulardii (SB) administration on very-low-birth-weight (VLBW) infants.Methods One hundred and ninety-eight preterm infants were prospectively randomized into observation group (105 cases) and control group (93 cases) based on the symptomatic and supportive treatment.When uncompletely stomach intestine nutrition fed,the patients of observation group took SB (50 mg/kg),the patients of control group took equivalent placebo.The times of defecation and diarrhea,the rate of neonatal necrotizing enterocolitis,hospital onset of infection (septicemia,pulmonary infection),fungal infection,the time of intravenous nutrition and length of stay were compared.Results The general data in two groups had no significant difference (P ＞ 0.05).The times of defecation,time of intravenous nutrition and length of stay in two groups had significant difference [(1.8 ± 0.4) times/d vs.(3.4 ± 0.5) times/d,(30.21 ± 3.43) d vs.(40.47 ± 4.35) d,(33.5 ± 6.8) d vs.(45.4 ± 9.3) d] (P ＜ 0.05).The rate of diarrhea,neonatal necrotizing enterocolitis,septicemia and pyemia in two groups had significant difference [14.3％ (15/105) vs.25.8％ (24/93),11.4％ (12/105) vs.19.4％ (18/93),19.0％ (20/105) vs.29.0％ (27/93)] (P ＜ 0.05).The rate of pulmonary infection and fungal infection between two groups had no significant difference(P＞ 0.05).Conclusion SB administration on VLBW infants can reduce the infection,promote enteral feeding,shorter hospital stay,and has a certain significance on the family and the community.

Objective To study the pulmonary surfactant (PS) on prevention of neonatal respiratory distress syndrome (NRDS) in neonates delivered via caesarean section. Methods From selective cesarean section infants (gestational age 34-38+6 W), 80 cases whose test tube oscillation tests were negative and amniotic fluid pulmonary surfactant associated protein A (SP-A) concentrations were lower than <10μg/L, and were randomly divided into PS prevention group and control group, with 40 cases in each group. PS prevention group within 1 h of birth were administrated poractant alfa injection by endotracheal tube (dose 100 mg/kg), but the control group was not given special treatment, leaving only the observation. The incidence of NRDS, treatment status and clinical progression were compared between two groups. Results The incidence of NRDS in control group was 82.5%(33/40), in PS prevention group was 37.5%(15/40), and there was significant difference (P<0.05). The degree of NRDS in control group was more severe. The incidence rate of persistent pulmonary hypertension of the new-born (PPHN), pulmonary air leak, patent ductus arteriosus and oxygenation index above 25 mmHg (1 mmHg=0.133 kPa) in control group were significantly higher than those in PS prevention group (P<0.05). The time of mechanical ventilation, the time of oxygen inhalation, ratio of arterial partial pressure of oxygen (PaO2) before mechanical ventilation to fraction of inspired oxygen (FiO2), and costs of hospitalization in control group were significantly higher than those in PS prevention group (P<0.05). Conclusions PS prevention can reduce the incidence of NRDS of neonates delivered by elective caesarean section, can alleviate the symptoms of NRDS, shorten length of stay and reduce the cost of hospitalization.

Objective To examine the effects of oxidative stress induced damage to the Prestin expression in HEI-OC1 cells,and to study the mechanism of sensory deafness.Methods We used different concentrations (50μM,100μM,200μM)of hydrogen peroxide canister to cultivate HEI-OC1 cells,and to detect the activity of su-peroxide dismutase(SOD).The quantitative real-time PCR and immunofluorescence were used to detect the prestin expression of mRNA.Results The SOD activity decreased in the HEI-OC1 cells damaged by oxidative stress.The high concentration of the infected group decreased more significantly(F= 9926.293,P<0.01).The expressions of Prestin mRNA and Prestin protein were decreased obviously in the HEI-OC1 cells.The high concentration of in-fected group decreased more significantly (F= 4065.046and7657.217,P<0.01).Conclusion Oxidative stress in-ducing damage inhibits the expression of prestin.Prestin protein may be used as a molecular marker of sensory deafness.

A competency dictionary of advanced health informatization application persons was compiled by inter-viewing 20 health information persons with behavior events interview , their competency characteristics were coded By Nvivo, the coding frequency and characteristics score in good performance group and ordinary group were ana-lyzed by variance analysis, which showed 8 characteristics of key competency and 12 characteristics of basic compe-tency in advanced health information application persons.

Objective To investigate the relenvant factors of precocious puberty and provide the basis for precaution of high risk group of precocious puberty .Methods A 1:1 case-control study was performed on 50 healthy girls and 50 precocious puberty girls .Results Univariate analysis showed an significant differences in the exposure rates of following five factors between cases and controls:intake of nutritious and health products ,favoring meat and poultry,long time watching television,addiction to TV ads,family economic condition (The Chi-square values are 7.045,9.073,17.478,14.063,12.246 respectively,all P<0.05).The Logisitc regression showed that favoring meat and poultry,long time watching television and addiction to TV ads had significant differences among precocious puber -ty children(The Wald′s Value were 4.846,6.850,5.662 respectively,all P<0.05).Conclusion favoring meat and poultry,long time watching television and addiction to TV play an important roles in precocious puberty .