Objective To investigate the effect of renal dysfunction on the prognosis of hospitalized patients with decompensated heart failure (DHF).Methods 191 patients with DHF hospitalized between June 2011 and June 2013 in Baoshan Branch of Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine were enrolled. These patients were divided into three groups according to the glomerular filtration rate (eGFR): normal renal function group (eGFR ≥ 90 mL·min-1·1.73 m-2, 63 cases), mild renal function descend group (eGFR 60 - 89 mL·min-1·1.73 m-2, 80 cases) and moderate or severe renal function descend group (eGFR < 60 mL·min-1·1.73 m-2, 48 cases). The general clinical data were recorded; the serum tumor necrosis factor-α (TNF-α) and interleukins (IL-1, IL-6, IL-8, IL-10, IL-13) were determined by enzyme-linked immunosorbent assay (ELISA). After discharge, the patients were followed-up for 1 year, and their outcomes were compared among the three groups.Results In 191 hospitalized patients with DHF, there were 67.0% with renal function impairment. Compared with normal renal function group and mild renal function descend group, the patients in moderate or severe renal function descend group were older (years: 83.4±5.1 vs. 66.2±5.4, 76.8±6.3), their cardiac functions were poorer, and their incidences of complications were higher than those in the normal renal function group [hypertension: 66.7% (32/48) vs. 42.9% (27/63), diabetes: 65.6% (31/48) vs. 41.3% (26/63), anemia: 37.5% (18/48) vs. 15.9% (10/63), acute myocardial infarction (AMI): 25.0% (12/48) vs. 9.5% (6/63), old myocardial infarction: 31.3% (15/48) vs. 11.1% (7/63), pulmonary infection: 29.2% (14/48) vs. 11.1% (7/63), allP < 0.05]. The complication incidences of hypertension [66.7% (32/48) vs. 51.3% (41/80)], diabetes [65.6% (31/48) vs. 48.8% (39/80)], anemia [37.5% (18/48) vs. 25.0% (20/80)] and pulmonary infection [29.2% (14/48) vs. 16.3% (13/80)] had no statistically significant differences between the moderate or severe renal function descend group and mild renal function descend group (allP > 0.05). The complication incidence of AMI [25.0% (12/48) vs. 10.0% (8/80)] and old myocardial infarction [31.3% (15/48) vs. 11.3% (9/80)] in moderate or severe renal function descend group was obviously higher than that in mild renal function descend group (bothP < 0.05). There were no statistically significant differences in the complication incidences of chronic obstructive pulmonary disease [COPD, 12.7% (8/63), 17.5% (14/80), 20.8% (10/48)], atrial fibrillation [30.2% (19/63), 27.5% (22/80), 29.2% (14/48)], ventricular premature beat [9.5% (6/63), 11.3% (9/80), 10.4% (5/48)] and cerebrovascular disease [20.6% (13/63), 22.5% (18/80), 22.9% (11/48)] among the three groups (allP > 0.05). Compared with normal renal function group, the levels of inflammatory cytokines in serum TNF-α, IL-1, IL-6, IL-8, IL-10, IL-13, and the mortality, the re-admission rates due to heart failure, rates of malignant arrhythmia in the two renal function descend groups were increased significantly, the increment being more remarkable in moderate or severe renal function descend group [TNF-α (ng/L): 235.8±20.9 vs. 121.6±10.7, IL-1 (ng/L): 345.9±40.8 vs. 203.5±34.7, IL-6 (ng/L): 502.8±64.2 vs. 321.9±53.8, IL-8 (ng/L): 723.9±210.3 vs. 431.5±110.5, IL-10 (ng/L): 155.4±23.5 vs. 103.1±13.2, IL-13 (ng/L): 184.5±27.3 vs. 136.8±20.2, the rate of mortality in the first time of hospitalization: 14.6% (7/48) vs. 5.0% (4/80), mortality within one year after discharge: 25.0% (12/48) vs. 18.0% (9/80), readmission rate due to heart failure: 47.9% (23/48) vs. 30.0% (24/80), rate of relapse of coronary events: 72.9% (35/48) vs. 37.5% (30/80), malignant arrhythmia rate: 39.6% (19/48) vs. 20.0% (16/80), allP < 0.05]. There were no significant differences in the rates of stroke among moderate or severe, mild and normal renal function descend groups [4.2% (2/48), 3.8% (3/80), 3.2% (2/63),P > 0.05].Conclusions The incidence of renal dysfunction in patients with DHF is relatively high, and their mortality, re-admission rate and their levels of inflammatory cytokines are high obviously. Thus, the intervention of renal dysfunction may have important significance in the improvement of their prognoses.

Objective To estimate the value of urinary neutrophil gelatinase-associated lipocalin (NGAL) level for early diagnosis of acute kidney injury (AKI) in patients with sepsis.Methods One hundred and twenty-six sepsis patients admitted to intensive care unit (ICU) in Baoshan Branch Hospital of Shuguang Hospital Affiliated to Shanghai University ofTraditional Chinese Medicine from June 2014 to December 2015 were enrolled, and they were divided into two groups according to whether complication of AKI was present. The levels of urinary NGAL in the two groups of septic patients were evaluated immediately and at 12, 24 and 48 hours after the definite diagnosis, and the levels were compared between the two groups; the receiver operating characteristic curve (ROC curve) was performed and the value of urinary NGAL level in early diagnosis of sepsis AKI was evaluated.Results There were 60 septic cases complicated with AKI (AKI group), with the prolongation of time after definite diagnosis, the urinary NGAL (g/L) levels were gradually increased at 12, 24 and 48 hours, the levels were significantly higher than those at the corresponding time points in the group without AKI [non AKI group (66 cases), 12 hours: 178.2±32.8 vs. 53.8±10.4, 24 hours: 228.4±24.6 vs. 54.1±9.0, 48 hours: 186.1±43.6 vs. 52.5±9.4, allP < 0.05]. The area under ROC curve (AUC) of urinary NGAL level at 24 hours after definite diagnosis and 95% confidence interval (CI) were 0.863 (0.766-0.929) and 0.686 (0.466-0.696), respectively, when the cutoff value of urinary NGAL was 65.9μg/L, the sensitivity was 81.9% and specificity 76.1%; when the cutoff value of urinary NGAL was 57.9μg/L, the sensitivity was 70.2% and the specificity 57.2%.Conclusion Urinary NGAL level can be used as a reference marker for the early diagnosis of sepsis concomitant AKI.

Objective To study the therapeutic effect and safety of pleurodesis with medical thoracoscopy by powdery talc on treatment of malignant pleural effusion.Methods Retrospective analysis were done in 74 cases of malignant pleural effusion accepted simple powdery talc pleurodesis under medical thoracoscopy.Results The doses of powdery talc were from 1g to 5g,average 2.18g in the course of the treatment.After operation,45 (60.8％) cases which were complete remission(CR) were full pleural adhesion and complete lung recruitment,14cases (18.9％),which were partial remission(PR),were less pleural adhesion and most lung recruitment,and 10cases(13.6％) were stable diseases(SD),while 5cases(6.7％),which were progressive diseases(PD),were without pleural reaction.The total effective rate,including CR,PR and SD,was 93.3 ％ (69/74).The complications of simple powdery talcage under medical thoracoscopy were included in:95.9％ (71/74) with chest pain,64.8％ (48/74) with fever,28.4％ (21/74) with shortness of breath,12.2 ％ (9/74) with mediastinal and subcutaneous emphysema,5.4％ (4/74) with nausea and vomiting,4.1％ (3/74) with abdominal distension,while the complications of acute pulmonary edema,massive hemorrhage,pulmonary embolism and wound infection were not observed.Conclusion Treatment of malignant pleural effusion by simple powdery talcage under medical thoracoscopy has definite clinic therapeutic effect,which is safe,cost-effective,less trauma and worthy of clinical application.

Objective: To apply and evaluate the effect of empowerment educational program on AIDS prevention and treatment among freshmen in one university. Methods: The method of two stage stratified sampling was used to select the experimental and control group. The traditional health education was implemented among the control group, and the empowerment education was implemented for the experimental group. The effect of the two groups was compared before and after intervention. Results: For experimental group, the awareness rate of AIDS(65.02%) ( χ 2=61.02， P <0.01) and the overall score of attitude and behavior(16.71± 2.53 )( t =-2.66， P <0.05) were significantly improved after intervention(82.96%，18.58±1.95). For the control group, there was significant difference in awareness rate of AIDS after intervention(67.70% vs 96.02%， χ 2=18.64, P <0.05), while there was no statistical difference in overall score of attitude and behavior after intervention(16.52±1.50 vs 17.16±1.57， t =-1.51, P =0.14). There was no significant difference in awareness rate between the two groups before intervention ( χ 2=0.36, P =0.55), but there was a statistical difference after intervention ( χ 2=20.42, P <0.01). There was statistical difference in attitude and behavior scores between the two groups after intervention ( P <0.05). Conclusion Empowerment educational program can improve the awareness rate of AIDS among college students, help to establish an objective attitude towards AIDS and infected patients, and to reduce high risk sexual behavior, also it is more effective compared to traditional education method.

OBJECTIVE: To investigate the current status of emotional intelligence and perceived professional benefits in undergraduate nursing student interns(hereinafter referred to as nursing student intern) and to analyze their correlation. METHODS: By convenience sampling method, 322 nursing student interns from 3 class A general hospitals in Nanchang City were selected as study subjects. Their emotional intelligence and the occupation benefits they obtained were investigated by Emotional Intelligence Scale and Nurses′ Perceived Professional Benefits Scale. RESULTS: The total average score of emotional intelligence was(3.6±0.6) and the average scores of each dimension item were others′ emotional assessment(3.8±0.6), self-emotional management(3.6±0.7), self-emotional use(3.6±0.7) and self-emotional assessment(3.5±0.7). The total average score of perceived professional benefits was(3.9±0.6) and the average scores of all dimensions were good nurse patient relationship(4.1±0.6), self growth(4.0±0.7), team belonging(3.9±0.6), family identity(3.9±0.6), and positive occupational perception(3.7±0.7). Emotional intelligence and its four dimensions were positively correlated with nursing perceived professional benefits and its five dimensions(P<0.01). Hierarchical multiple regression analysis results showed that, emotional assessment of others and self-emotion management had a positive predictive effect on perceived professional benefits, and explained 41.5% of the variance. CONCLUSION: The emotional intelligence of nursing student interns and their perceived professional benefits were positively correlated. Nursing educators could improve the perceived professional benefits of nursing student interns by strengthening the training of emotional intelligence.