Objective To investigate the role and clinical significance of estrogen in the proliferation of colorectal carcinomas (CC). Methods The estrogen receptor (ER) expression and the Cyclin D 1 expression were quantitatively determined by flow cytometry in 30 cases of CC and 10 cases of normal colorectal tissues (NCT). Meanwhile, the expressions of ER and proliferating cell nuclear antigen (PCNA) protein were exa mined immunohistochemically in the same cases. Results FCM analysis showed that the ER expression in CC (1.36?0.32) was significantly stronger than that in NCT(1.00?0.05, P

Objective To understand the level of clinical first aid ability of nurses in non-emergency department of third-class general hospitals of Taiyuan City, and to provide theoretical basis for effective intervention of nursing managers. Methods A questionnaire survey was conducted among 1008 nurses in 5 third-class general hospitals in Taiyuan city. Results The total score of clinical first aid ability of the non-emergency department nurses in 5 third-class general hospitals of Taiyuan was (121.29 ± 12.19) points.There were significant differences in scores of different age, education, nursing age, grade, title and departmental nurses (F=25.584-128.611, P<0.01). There was only a difference in the theoretical knowledge reserve in different department (F=3.589, P<0.05). The effect of the first aid ability on the emergency first aid ability of the non-emergency department nurses was the energy level, the education degree and the first aid ability of the nurses are increasing with the education level and the energy level. Conclusions In clinical work, nursing managers should pay attention to the development of first aid ability of low-grade and low-educated nurses in non-emergency department, and can carry out the training for first aid and comprehensive ability by situation simulation, emergency plan exercise, process management and so on.

Objective:To investigate the clinical efficacy of Yunkang oral liquid combined with dexamethasone and low-molecular-weight heparin in the treatment of recurrent spontaneous abortion (RSA) complicated with pre thrombotic state (PTS), and its effects on thromboelastogram and serum progesterone, β-human chorionic gonadotropin (β- hCG), and helper T cell (Th) 1/Th2 cytokine levels in patients with recurrent spontaneous abortion (RSA).Methods:A prospective selection of 94 RSA patients with PTS admitted to the Baoding Second Central Hospital from January 2015 to December 2020 was conducted. They were randomly divided into two groups using a random number table method, with 47 patients in each group. The control group was treated with dexamethasone combined with low molecular weight heparin, while the observation group was treated with Yunkang oral liquid in addition to the control group. Continuously treat until 12 weeks of pregnancy to evaluate the efficacy of both groups and observe the adverse reactions in both groups. Two sets of thromboelastogram parameters were compared before and after treatment, including clot formation time (K value), clot reaction time (R value), and clot formation rate (α angle), maximum clot strength (MA value), and coagulation comprehensive index (CI), as well as serum progesterone β- hCG, Th1/Th2 cytokine levels. The pregnancy outcomes of the two groups were followed up.Results:The total effective rate of the observation group [95.7%(45/47)] was significantly higher than that of the control group [83.0%(39/47), P<0.05]. After treatment, the K and R values of both groups were significantly prolonged compared to before treatment (all P<0.05), the angle α, MA value, and CI value were significantly reduced compared to those before treatment (all P<0.05); After treatment, the K and R values in the observation group were significantly longer than those in the control group (al P<0.05), The angleα, MA value, and CI value were significantly lower than those of the control group (all P<0.05). After treatment, the levels of β- hCG serum progesterone of the two groups were significantly higher than those before treatment (all P<0.05), and The β-hCG levels of the serum progesterone were all higher than those in the control group (all P<0.05). After treatment, The levels serum Th1 cytokines [interferon-γ (INF- γ), tumor necrosis factor- α (TNF- α)] of both groups were significantly decreased compared to those before treatment (all P<0.05), and the levels of serum Th2 cytokines [interleukin-4, IL-10] were significantly increased compared to those before treatment (all P<0.05); After treatment, the observation group's serum IFN- γ, TNF- α were significantly lower than those of the control group (all P<0.05), and The levels of serum IL-4 and IL-10 were significantly higher than those of the control group all P<0.05). The live birth rate of the observation group was 87.2%(41/47), which was higher than that of the control group [70.2%(33/47)] ( P<0.05). There was no statistically significant difference in the adverse reaction rate between the observation group [6.4%(3/47)] and the control group [4.3%(2/47)] ( P>0.05). Conclusions:The treatment of RSA combined with PTS with Yunkang oral liquid, dexmedroxyprogesterone, and low molecular weight heparin can significantly alleviate blood hypercoagulability, increase reproductive endocrine hormone levels, regulate Th1/Th2 cytokine balance, improve live birth rate and clinical efficacy, and is safe and reliable.

Objective To explore the clinical value of maternal and umbilical blood inflammatory markers,interleukin-6 (IL-6),neutrophil-to-lymphocyte ratio (NLR),C-reactive protein (CRP) and procalcitonin (PCT),in the diagnosis of histologic chorioamnionitis (HCA).Methods A total of 102 suspected chorioamnionitic cases were enrolled from January 2014 to July 2017.They were assigned into two groups based upon postpartum histopathological examination of placenta:HCA group (48 cases) and control group (54 cases).Maternal and umbilical blood samples were collected for routine blood test and tested for IL-6,NLR,CRP and PCT levels.T,Mann-Whitney U or Chi-square (or Fisher's exact) test was used for data comparison.Meaningful indicators in maternal and umbilical cord blood were analyzed by logistic regression analysis and correlation analysis.At the same time,receiver operating characteristic (ROC) curve was drawn to evaluate their diagnostic values.Results (1) IL-6 level and NLR in maternal blood in HCA group were higher than those in control group [6.95 (2.40-13.50) vs 3.90 (2.30-9.20) pg/ml,Z=-5.147;5.03 (1.92-9.20) vs 3.94 (1.85-11.17),Z=-3.097;both P＜0.05],and the levels of white blood cells,neutrophile granulocytes,CRP and IL-6 as well as NLR in umbilical cord blood were also higher [(9.4± 2.0)× 109/L vs (8.6 ± 1.4)× 109/L,t=-2.522;(6.87t1.62)× 109/L vs (5.99± 1.26)× 109/L,t=-3.071;12.30 (0.50-89.04) vs 3.18 (0.50-88.93) mg/L,Z=-4.519;(8.78±2.56) vs (4.78±1.45) pg/ml,t=-7.025;(4.45±1.36) vs (3.78±1.22),t=-3.020;all P＜0.05].(2) Logistic regression analysis showed that elevated levels of IL-6 and NLR in maternal blood and CRP and IL-6 in umbilical cord blood were independent risk factors for HCA [OR (95％CI):1.65 (1.32-2.06),1.34 (1.02-1.77),1.05 (1.00-1.11) and 2.39 (1.72-3.32),all P＜0.05].Positive correlations were found between the levels of IL-6 in maternal and umbilical cord blood,and between NLR in maternal blood and CRP level in umbilical cord blood (correlation coefficient:0.680 and 0.230,both P＜0.05).(3) IL-6 level in umbilical blood was of the greatest value in the diagnosis of HCA among all single markers,followed by IL 6 in maternal blood,CRP in umbilical blood and NLR in maternal blood [area under the ROC curve (AUC):0.904,0.796,0.760 and 0.678].When two indexes were combined,NLR in maternal blood+IL 6 in umbilical cord blood showed the highest diagnostic value,followed by,IL 6 in maternal blood+CRP in umbilical cord blood,IL-6+NLR in maternal blood and NLR in maternal blood+CRP in umbilical cord blood (AUC:0.917,0.870,0.823 and 0.791).When three indexes was used in combination,the diagnostic value of IL-6 in maternal and umbilical cord blood+NLR in maternal blood was higher than that of IL-6 and NLR in maternal blood+CRP in umbilical cord blood (AUC:0.919 and 0.836).(4) There were 13 cases (27.1％) with neonatal complications in HCA group and two (3.7％) in control group (P＜0.05).Conclusions Changes in NLR and IL-6 levels in maternal blood and NLR,IL-6 and CRP levels,and white blood cells and neutrophile granulocytes counts in umbilical cord blood are associated with HCA.The diagnostic efficacy of two indexes combined is superior to that of single index,while the combination of three indexes can significantly improve the diagnostic accuracy and authenticity.

Objective:To identify the risk factors for intrapartum fever during labor analgesia and establish the prediction model.Methods:The medical records from pregnant women with intrapartum fever during labor analgesia were retrospectively analyzed. According to whether the highest body temperature ≥38 ℃, the parturients were divided into intrapartum fever group and non-fever group. The general data from patients, duration of hospital stay before labor, induced labor, prenatal hemoglobin concentration, body msaa index (BMI) during pregnancy, artificial rupture of membranes in the incubation period, frequency of vaginal examination and etc. were collected. The risk factors of which P values were less than 0.05 would enter the logistic regression analysis to stratify intrapartum fever-related risk factors, and the weighted score regression prediction model was established. Hosmer-Lemshow Test was used to assess the fit of the model, and the receiver operating characteristic curve was drawn to evaluate the model. The nomogram was drawn for visually presenting the regression model. The clinical calibration curve, decision curve analysis and clinical impact curve were drawn to assess the created prediction model. Results:There were 99 parturients developed fever during labor analgesia, with an incidence of 34.7%. The results of logistic regression analysis showed that duration of hospital stay before labor, prenatal hemoglobin concentrations, BMI during pregnancy, induced labor, artificial rupture of membranes in the incubation period and frequency of vaginal examination were the independent risk factors for intrapartum fever during labor analgesia. The area under the receiver operating characteristic curve was 0.943, 95% confidence interval was 0.916-0.969, the sensitivity was 86.9%, the specificity was 88.6%, and the Youden index was 0.755. The prediction model of the line chart was assessed by Hosmer-Lemshow, P=0.898. Conclusions:Duration of hospital stay before labor, hemoglobin concentrations, BMI during pregnancy, induced labor, artificial rupture of membranes in the incubation period and frequency of vaginal examination are independent risk factors for intrapartum fever during labor analgesia in parturients, and the risk prediction model developed can effectively predict the occurrence of intrapartum fever during labor analgesia.

Objective To understand the prevalence of nosocomial infection and its potential risk factors through a cross-sectional study, to construct a predictive model of the probability of nosocomial infection, and to provide a basis for nosocomial infection management. Methods The prevalence rate of nosocomial infection and potential risk factors of all inpatients in a tertiary general hospital were investigated on a certain day. The possible risk factors of nosocomial infection were analyzed, and a nomogram prediction model on the probability of nosocomial infection was established. The calibration curve and ROC curve were used to evaluate the predictive efficiency of the model. Results A total of 419 hospitalized patients were investigated, and the prevalence rate of nosocomial infection was 3.58%. The top three nosocomial infections were in ICU, neurosurgery, and cardiac surgery. The top three infection sites were surgical site infections, lower respiratory tract infections, and urinary tract infections. The results of univariate analysis showed that the length of hospital stay, surgery, antimicrobial use and underlying diseases were statistically related to the occurrence of nosocomial infections (all P<0.05). Logistic regression analysis showed that compared with the length of stay (LOS)＜14, the risk of nosocomial infection in patients with long LOS (≥14) was 5.48 (95% CI: 1.68-19.16). The risk of nosocomial infection in patients with two basic diseases was 7.61 times that (95%CI: 1.50-44.79) of patients without underlying diseases. The risk of nosocomial infection in patients with surgery was 4.88 times that of patients without surgery (95%CI: 1.47-19.6). According to the coefficients of the related risk factors calculated by logistic regression, a nomogram model of the occurrence probability of nosocomial infection was established. The C-index of the model was 0.839, and the area under the ROC curve for predictive efficiency was 0.809 (95%CI: 0.740-0.942). Conclusion Nosocomial infection control and management should be strengthened. Individual risk assessment of patients' nosocomial infection should consider about the age, underlying diseases, surgical status, glucocorticoid or immunosuppressive agents, and antimicrobial drug use. It is essential to identify the high-risk groups as soon as possible and take prevention and control measures to reduce the prevalence rate of nosocomial infection.