Objective To study the main influence factors of nosocomial infection(NI) and establish a model to predict and forecast the risk of NI on patients in hospitals. Methods Clinical data of 27352 inpatients extracted from hospital information system were sorted out and coded, and a logistic regression model about the probability of NI was established. The risk of NI was divided into four scales. Results With multiple factor analysis,16 risk factors of NI were identified, which were age, high body temperature, numbers of diagnosis, days of staying in hospital and seriousness, numbers of routine test for urine, times of blood transfusion, use or without use of antibiotic and radiotherapy, turning over the bodies or not, relationships between infection and interventional operations, with or without diabetes, categories of diseases based on ICD-9, numbers of interventional operations, type of anesthesia and department of admission. If NI was judged when predicted probability(Pr)of logistic regression model exceeded 0 35, the specificity and false diagnostic rate of diagnostic test were 0 995 and 0 005 respectively, and the area under ROC curve was 0 986. According to decision tree method, the risk of NI was classified into four degrees: low (Pr

Objective The objective of this study was to investigate the expression of P28 and P43 in papillary thyroid carcinoma(PTC)and its relationship with clinicopathological features after TRa1 gene transcription.Methods Real-time fluorescence quantitative PCR(RT-PCR)and gel electrophoresis were used to determine the target fragments and to isolate the bands of different fragments.The optical density of each band was scanned by UV transmittance analyzer to detect 31 cases of PTC tissue and expression levels of P28 and P43 in para-cancerous tissues.Results The average gray value of P28 in thyroid carcinoma group was 0.77±0.34,which was significantly higher than that in para-cancer group(0.31±0.18).The average gray value of P43(0.85+0.21)in thyroid carcinoma group was significantly higher than that in para-cancer group(0.34±0.15)(P<0.05).The expression levels of P28 were not correlated with gender,age,tumor size,lymph node metastasis and clinical pathologic stage(P>0.05),The expression levels of P43 were not correlated with gender,age,tumor size and lymph node metastasis.(P>0.05)but they were related to clinical pathologic stage(P<0.05).There was no correlation between expression levels of P28 and P43(r=0.266,P=0.071).Conclusion The increased expression of P28 and P43 may have a high degree of malignancy and a certain clinical value in predicting the adverse prognosis of PTC.Both factors are helpful for the prevention and treatment of PTC.

Objective To explore the methods of the nutritional support of children with severe sepsis.Methods The biochemical index,nutrition index,blood gas,blood routine and 24 hours urinary urea nitrogen of 198 children with severe sepsis were detected after hospitalization.Enteral nutrition,parenteral nutrition,or enteral and parenteral nutrition at the same time were selected for every children according to patients status.Children with parenteral nutrition were divided into glutamine (Gln) group and non-Gln group.Nutrition and metabolism indexes of survival and dead children were detected,including blood glucose,C-reactive protein,hemoglobin (Hb),pH,blood sodium,blood potassium,alanine transaminase,blood urea nitrogen,creatinine,blood lacticacid,lactate clearance rate,blood triglycerides,blood total cholesterol,serum pre-albumin (PA),retinal-binding protein (RBP),serum albumin (ALB) and 24 hours urinary urea nitrogen.The intake of calories were compared between survival and dead children before nutrition support (0 d),3 d and 7 d after nutrition support.Immunoglobulins of Gln group and non-Gln group were compared.Results The nutrition indexes of the survival group were higher than those of dead group [PA (130.0 ± 30.0) mg/L vs (50.8 ±20.5) mg/L,RBP(22.3 ±10.3) mg/L vs (15.7 ±6.7) mg/L,ALB(35.3 ±8.1) g/L vs (28.7 ±6.2) g/L,Hb(113.2 ±27.7) g/L vs (95.3 ±10.6) g/L,IgA(0.40 ±0.03) g/L vs (0.40 ±0.03) g/L,IgM(0.52 ±0.18) g/L vs (0.49 ±0.03) g/L] (P ＜0.05).The intake calories of survival group in 3 d and 7 d after nutrition support were (50.32 ±2.76) kcal/(kg·d) and (65.70 ±3.25) kcal/(kg·d),which were significantly higher than those of dead group [(32.54 ± 1.72) kcal/(kg·d) and (46.12 ± 1.08) kcal/(kg·d)).Among the survival children with parenteral nutrition,the levels of immunoglobulin in Gln group were higher than non-Gln group [IgG(4.93 ± 2.1) g/L vs (4.01 ± 1.03) g/L,IgA (0.31 ± 0.07) g/L vs (0.19 ±0.03) g/L,IgM(0.52 ±0.08) g/L vs (0.32 ±0.10) g/L] (P ＜0.05).Negative nitrogen balance was better in Gln group as(-2.5 ± 1.4) g/d than non-Gln group as (-5.3 ± 1.3) g/d(P ＜0.05).Conclusion Children with severe sepsis manifeste significantly increased metabolic rate and energy consumption,the protein decomposition utilization is greater than the synthetic with negative nitrogen balance.Children with more severe sepsis have lower metabolic indexes,nutrition indexes,and immunoglobulin.It is necessary for children with severe sepsis to use glutamine while having parenteral nutrition.

Purpose/Significance To conduct a cross-metric analysis of citations and cited references of highly cited medical infor-matics articles in the first quartile of the journal citation reports(JCR)over the past 10 years,and to analyze the sources of citing disci-plines and the origins of cited disciplines.Method/Process The screened data is divided into citation literature data and citing literature data.Statistics are performed from the perspective of secondary disciplines,and the general analysis is carried out from the perspective of first-level disciplines.The measurement indicators are set as discipline diversity,discipline balance,discipline continuity and disci-pline interdisciplinarity,which are analyzed respectively from the perspectives of citations and citing.Result/Conclusion The interdisci-plinary characteristics of medical informatics include a wide range of disciplines involved,consistent and stable external influence,and a tendency towards certain cross-disciplinary objects,and on this basis,the suggestions for disciplinary development are proposed.

Objective To investigate the strategy of cardiopulmonary resuscitation (CPR) after lung protective mechanical ventilation in critical children and follow-up study of the survivals 90 d after discharge.Methods Four hundred and eighty-nine cases of respiratory cardiac arrest which occurred for various reasons from January 2011 to June 2016 were analyzed in Pediatric Intensive Care Unit (PICU) in Guiyang Children's Hospital,in which mechanical ventilation was performed after CPR in 251 cases,death,or giving up treatment within 24 h in 83 cases,children surviving ＞ 24 h in 168 cases,118 cases were assigned into small tidal volume ventilation group,and 50 cases into conventional tidal volume ventilation group,and according to the tidal volume to adjust positive end expiratory pressure ventilation (PEEP),and the oxygen partial pressure [pa (O2)] and the oxygen index (OI),the change of the indexes of blood gas analysis,lactic acid clearance,and oxygenation were also observed.To observe the complications of mechanical ventilation,the situation of withdrawing machine as well as the outcome of the children.Follow-up was conducted for 90 d,including continuous respiratory symptoms,lung imaging examination after discharge and lung function,nervous system examination.Results (1) After mechanical ventilation treatment of 48 hours,compared with the levels of fractional inspired oxygen (FiO2) (0.42 ± 0.15 vs.0.43 ± 0.22),pa (O2) (8.25 ± 0.22 vs.8.27 ± 0.68),OI (5.33 ± 2.01 vs.6.59 ± 1.99) and lactic acid clearance(61.05 ± 1.87 vs.60.93 ± 2.71) between the routine tidal volume ventilation group and the lower tidal volume ventilation group,showing that the difference had no statistical significance (t =1.645,1.165,2.302,2.037,all P ＞ 0.05).(2) In small tidal volume group,the incidence of ventilator associated lung injury was significantly lower than that in the conventional tidal volume group,and the difference was statistically significant (x2 =5.873,P ＜ 0.05).(3) Comparing 2 groups of different tidal volume ventilation,the mortality of critical ill children had no statistically significant difference (x2 =1.063,P ＞ 0.05).(4) One hundred and twenty-seven cases of children survived and were discharged,and compared with their discharge,the follow-up of 62 cases after discharge for 30 d,90 d showed that all the children's lung function improved,tidal volume,inspiratory and expiratory time ratio(I/E),volume ratio of peak(VP/VE),time ratio of peak(TP/TE) and breathing rate(RR) were also improved,and there was significant difference (F =43.225,6.108,68.821,78.237,20.361,all P ＜ 0.05).(5) Neurological examination and children's brain function classification rating scale showed that some children had nerve dysfunction.Conclusions Small tidal volume ventilation in reducing the occurrence of ventilator associated lung injury is superior to the conventional tidal volume ventilation.To improve case fatality rate of the children with cardiac arrest resuscitation and oxygenation is not better than the conventional tidal volume group.Dynamic monitoring is helpful to adjust breathing mechanics indexes and parameters and ventilator.Through the follow-up most of the discharged children recovered well,but a few had recurrent respiratory infection and neurological sequelae.

OBJECTIVE: To study the relevant information on the label of health food in Changsha, and provide scientific evidence for health food hygienic supervision. METHODS: Investigation was conducted in department stores, supermarkets, pharmacies, and wholesale markets in the 5 districts in Changsha with multistage stratified sampling method. Self designed basic information of health food questionnaire was used to investigate the quality of labels the health food products. RESULTS: Among the 408 random samples, the unidentified rates of label items were ranked in descending order: functional components (49.8%), unsuited community (27.9%), manufacturing date (23.0%), approval number and others (9.6%). The qualified rates of labels were different in different management types (χ(2)=59.793, P<0.05): the highest rate was in supermarkets (71.15%), followed by pharmacies (70.07%), shopping malls (57.47%), and wholesale markets (26.23%). CONCLUSION The supervision of label identities of health food should be strengthened, especially for the health food in the wholesale markets.
China ; Dietary Supplements ; Food Labeling ; Food, Organic ; Humans ; Sampling Studies ; Surveys and Questionnaires

OBJECTIVE: To evaluate the rationality and validity of weighted TOPSIS method and weighted RSR method to evaluate drug supervision and supply networks construction in rural areas of Hunan . METHODS: Data of drug network construction in rural Hunan in 2010 were used to establish a comprehensive evaluation model, and weighted TOPSIS and RSR method were applied to this model and the results of which were compared to that of synthetical scored method to examine the validity. RESULTS: A comprehensive evaluation model was established, comprising of 3 primary indices, 8 secondary indices and 56 tertiary ones. The result of weighted RSR method was highly correlated to that of synthetical scored method, yet the result of TOPSIS was less correlated to the formers. All correlations were significant (P<0.01). CONCLUSION Both weighted RSR and TOPSIS are not perfect methods, but the application of the methods in drug network evaluation is scientific and effective.
China ; Computing Methodologies ; Decision Support Techniques ; Fees and Charges ; Models, Theoretical ; Pharmaceutical Preparations ; standards ; supply & distribution ; Rural Health Services

OBJECTIVE: To establish a more reliable and accurate scale of perinatal maternal health literacy during perinatal period by selecting items form existing scale. METHODS: Two rounds of inquiry were performed by 14 experts on mother and children to evaluate the necessary and importance of 56 items by Delphi method, in which 50 items were retained. Th en we proceeded a cross-sectional survey in 350 woman who just gave birth 1-3 days before. 10% of them were selected to retest aft er 1 week. Based on these data, we used 6 different methods to select items and kept those that could pass by at least 3 different methods. The methods used in data analysis were Chi-square test, correlation coefficient method (2 kinds), factor analysis, Cronbach α coefficient method and the retest reliability method. RESULTS: The Person correlation coefficient was 0.507 (P=0.004). By using the 6 statistical methods, we deleted 9 items through Chi-square test, 25 items through correlation coefficient method 1, 1 item through correlation coefficient method 2, 19 items through Cronbach α coefficient method, 8 items through factor analysis and 37 items through retest reliability method. In the end, 33 items were retained for the novel scale of maternal health literacy during perinatal period. CONCLUSION Simplified novel scale is acquired, which need to do large efforts before extensive use, such as large sample survey, reliability and validity test.
Cross-Sectional Studies ; Delphi Technique ; Factor Analysis, Statistical ; Female ; Health Literacy ; Humans ; Mothers ; Postnatal Care ; Reproducibility of Results ; Surveys and Questionnaires

In the context of the digital economy， the operational relationship between traditional Chinese medicine （TCM） and Internet healthcare organizations as well as related governance institutions has attracted much attention. As the market scale of the Internet healthcare has continued to grow in recent years， the quality of Internet TCM healthcare has also been improved. By analyzing the development status of Internet TCM healthcare， it is proposed that Internet TCM health service should seize the opportunities and challenges in future， promote the growth of market scale from varied aspects， enhance patient-centered care awareness， and strengthen the promotion and popularization of digital services， thereby promoting the high-quality development of Internet TCM health service in the context of the digital economy.

OBJECTIVE: To explore the knowledge of, attitude to and practice in nutrition and food safety, the influence factors, and to provide reference for relevant health education programs. METHODS: A total of 510 randomly selected students from Grade 1 to 3 randomly selected were surveyed by a nutrition and food safety questionnaire in Huize of Yunnan Province and Zhen'an of Shaanxi Province. Multiple-linear regression was used to analyze the influence factors of nutrition and food safety. RESULTS: The correct answer rate on nutrition and food safety knowledge of the pupils from Grade 1 to 3 was 74.4%. Nutrition and food safety knowledge score was 11.16±2.51, but only 7.8% of the students correctly answered "How much water should we drink every day". Students who agreed that it is necessary to learn nutrition and food safety knowledge in school accounted for 78.6% and 73.9%, respectively. At least half of the students showed correct behaviors in 7 aspects. The students who ate beans and meat daily or regularly accounted for 28.4% and 34.9%, but only 9.2% of the students drank more than 7 cups of water daily. The multiple-linear regression showed that the major influence factors were the area, grade, status of lodge and singleton. CONCLUSION Education is needed for students to form better dietary habits, especially those in low grades, non-singleton, and in board schools.
Child ; China ; Feeding Behavior ; Female ; Food Safety ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; Nutritive Value ; Students ; Surveys and Questionnaires