Objective To perform APACHEⅡand SOFA in assessmentof EICU patients with sepsis ,and analyze the risk factors. Methods A retrospective analysis from January 2014 to October 2015 in EICU of our hos-pital ,a total of 83 patients suffered from sepsis ,including sepsis group(30 cases)and septic shock(53 cases). PCT,PT,APTT,lactic acid,mechanical ventilation time and APACHE Ⅱ and SOFA score were collected, through the receiver-operating characteristic curve(ROC)index to predict the prognosis of patients with sepsis.Re-sults The mortality of the patients in the septic shock group,PT,APTT,APACHEⅡ,SOFA score,mechanical ventilation time and PCT were significantly higher than thosein the sepsis group(P<0.001). APTT,APACHEⅡ, SOFA score and mechanical ventilation time had significant difference (P ≤ 0.001) between survival and dead. The lactic acid level of the dead group was significantly higher than that in the survival group(P=0.038). The ar-ea under curve(AUC=0.806)of APACHEⅡscore was better than the SOFA score(AUC=0.765).The outcome of sepsis had correlation with APACHEⅡ,SOFA score,lactic acid,and mechanical ventilation time(P<0.05). Conclusion APACHE II and SOFA scores can accurately predict mortalityoutcome in emergency intensive care units patients with sepsis,especially the APACHEⅡscore.We can measure blood coagulation function,APACHEⅡ,SOFA score,PCT,lactic acid and mechanical ventilation time to assess the severity of patients with sepsis.

Objective To evaluate the value of transvaginal ultrasound in the diagnosis of tubal pregnancy.Methods The retrospective analysis was made according to transvaginal ultrasound inspection on 77 patients and their sonographic appearance and ultrasonic diagnosis of tubal pregnancy proved by surgery and pathology.Results The two-dimensional sonogram mainly showed the adnexal masses and the liquid area opaca in the pelvic cavity.The masses were divided into three types:germ heart-beat type,gestational sac type,and uneven mixed mass type.According to distinctive two-dimensional sonographic appearance,the accuracy rates of transvaginal ultrasound in the diagnosis of rupture,nonrupture,and abortion tubal pregnancy were 87.23%,100%,and 34.62%,respectively.In combination with pelvic mass,indirect sign of effusion,and patient history,the accuracy rates of ultrasonic diagnosis in the above clinical classifications were 95.74%,100%,and 84.61%,respectively.The accuracy rate of the total ultrasonic diagnosis was 92.21%.Conclusions Transvaginal ultrasound has higher accuracy in the diagnosis of rupture and nonrupture tubal pregnancy,but it lacks distinctive sonographic appearance in the diagnosis of the majority of abortion tubal pregnancy,which is the main reason for affecting the accuracy of ultrasonic diagnosis of tubal pregnancy.

Objective To evaluate the characteristics of the haemodynamics of the hysteromyoma and its diagnosis value. Methods To apply the transvaginal color doppler ultrasound to detect the blood flow parameters of the uterine artery and the muscular tumor’s peripheral and inner area from 68 patients with hysteromyoma, compared with the blood flow parameters of the uterine artery from 50 normal women so as to analyze their difference. Results (1) In the hysteromyoma group, the maximum blood flow velocity during the systolic phase (SP) and the minimum blood flow velocity during the end-diastolic phase (ED) of uterine artery are significantly higher than those in the normal group(P

Objective To investigate the anxious behavior in acute parkinson's mice that were induced by 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) injection.Methods Twenty mice were randomly divided into the control group (n =10) and model group(n =10);The model group was induced by injecting MPTP dosage,and the control group was induced by the same dose of saline.The anxious behaviors in mice were tested by the elevated plus-maze test and the light/dark box.Results The model group mice spent a longer time than the control group in the dark box (P ＜ 0.05).The open arm entry (OE),open arm time (OT) and OE％ of model group was significantly less than that in control group in the elevated plus-maze test (P ＜ 0.01),the OT％ was significantly less than control group (P ＜0.05).Conclusions Anxiety symptoms appeared in the model group of early parkinson disease (PD)mice.

Objective To detect the clinical effect of posterior reduction combined with H-shaped bone grafting and spinous process replantation for reconstruction of spinal structures in treatment of thoracolumbar fracture.Methods Forty-three patients with thoracolumbar burst fracture treated surgically from February 2008 to June 2012 were reviewed retrospectively.There were 30 male and 13 female patients aged 23 to 55 years (mean,38 years).Fracture resulted from high falls in 21 patients,traffic accidents in 16 patients,and a crush by heavy objects in 6 patients.Denis system was used for classification of fracture and Frankel rating for assessing the degree of nerve damage and recovery.After posterior reduction combined with H-shaped bone grafting and spinous process replantation for all patients,visual analogue scale (VAS) was utilized to assess symptom improvement and Cobb' s angle and sagittal spinal canal diameter were measured to help assess the treatment outcome.Results Pain was apparently eased at a 24-month follow-up (range,12-46 months).Cobb' s angle improved from preoperative 43.56° to postoperative 8.23° (t =1.33,P ＜ 0.01).CT findings showed mean spinal canal stenosis rate was 56.3％ before surgery and that mean sagittal canal diameter of the injured spine was larger than that of adjacent segments at follow-up,with the mean ratio of 116.3％ (range,111.3％-120.3％).Rate of spinal canal stenosis was negative for all patients and posterior canal with bone grafts healed.Spinal cord injury improved at least one Frankel grade.Conclusion Posterior reduction combined with H-shaped bone grafting and spinous process replantation is worthy of clinical application,for the procedure can restore the fractured thoracolumbar spine and posterior canal structure,but also effectively avoid the iatrogenic spinal stenosis.

Objective To explore the effect of early virtual reality training in the rehabilitation of stroke patients with hemiplegia.Methods From June 2015 to May 2016, 60 cases of stroke patients from the Department of Rehabilitation of the First Affiliated Hospital of Wenzhou Medical University were randomly divided into observation group and control group, 30 cases in each group. The patients of control group received routine rehabilitation training program, and patients of the observation group received routine rehabilitation and virtual reality training. The two groups were trained for 6 weeks. The walking function, activities of daily living and mental status of the patient before and after training were evaluated by functional ambulation category scale (FAC), modified Barthel index (MBI), hospital anxiety and depression scale (HAD).Results Before training, FAC, MBI and HAD scores had no significant difference between patients of two groups (P>0.05). After 6 weeks of training, the scores of FAC, MBI and HAD in the two groups were better than those before training (P<0.05); After training, except for HAD (D), the indexes in the observation group were better than those in the control group (P<0.05).Conclusions Early virtual reality training can effectively improve the walking function and activities of daily living in stroke patients with hemiplegia, and relieve the patients' unhealthy psychological emotion.

Objective To explore the application of the infusion management system in ICU and its effect on the major nursing risk factors .Methods One hundred and five patients with top ten diseases in ICU from March 2013 to December 2013 were chosen and were randomly divided into the control group ( n=50 ) and the observation group ( n =55 ) .The control group received the management of liquid therapy through the monomer infusion pump , and the observation group received the management of liquid therapy through B .Braun infusion therapy system .The average time of liquid therapy , the rate of unplanned extubation , the error rate of vasoactive drugs and the nurses ’ satisfaction of two groups were observed .Results The average time of liquid therapy, the rate of unplanned extubation , the error rate of vasoactive drugs and the nurses ’ satisfaction were respectively (65.3 ±21.4)h, 7.3%, 7.3%, 92.7%in the observation group, and were better than (99.4 ± 27.8)h, 16.0%, 14.0%, 56.0% in the control group, and the differences were statistically significant (t/χ2 =2.63, 7.25, 5.38, 8.68, respectively;P<0.05).Conclusions Application of B.Braun infusion therapy system in ICU can reduce the workload of nurses , and decrease the rate of unplanned extubation and the error rate of vasoactive drugs in patients , and increase the nurses ’ satisfaction.

Objective:To investigate the effects of chronic stress during pregnancy on depressive behavior and DNA methylation of insulin-like growth factor-2 ( IGF-2 )/long non-coding RNA ( lncRNA ) H19 in hippocampus of female offspring rats.Methods:A total of 32 SPF female SD rats were divided into model group and control group according to the random number table. The rats in the model group were treated with chronic unpredictable mild stress (CUMS) to establish the depression model, and the rats in the control group were fed normally.On the 7th day of stress stimulation, all female rats mated with male rats. One day before stress stimulation and 1, 7, 14, 21, 28 days after stress stimulation, blood samples were collected from the inner canthus vein of the rats to determine the plasma corticosterone concentration. Eight female pups were randomly selected from each group on postnatal day 28(PND28) and postnatal day 42 (PND42). Plasma corticosterone concentration was measured after angular vein blood collection. At PND42, the depression-like behavior of female pups in the two groups was measured by sucrose preference test, tail suspension test and forced swimming test. The expression of IGF-2/H19 and related transferases in hippocampus of offspring rats was detected by RT-PCR and Western blot. Methyl target technology was used to capture and sequence 19 CpG sites of IGF-2 differentially methylated region(DMR) fragment 2, 8 CpG sites in H19 imprinting control region (ICR) fragment 1 and 15 CpG sites in H19-ICR fragment 2, and calculate the methylation level of each CpG site. SPSS 26.0 was used for statistical analysis of relevant data by repeated measurement ANOVA, t test and non-parametric test. Results:(1) The data of plasma corticosterone content of the two groups of female rats at different times were analyzed by repeated measurement variance.The results showed that the the interaction effect between time and group was not significant ( F=2.997, P=0.066), and the main effect of time was significant ( F=4.44, P=0.010). The main effect of group was significant ( F=41.40, P=0.001). According to the independent effect analysis of factors between groups, on the 14th, 21st, and 28th days of stress, the plasma corticosterone concentration of the model group was higher than that of the control group (all P<0.001). (2) In the sucrose preference test, the total liquid consumption (11.10(10.38, 11.58) mL, 13.55(12.00, 15.77) mL, Z=-3.055, P=0.002), 1% sucrose water consumption ((5.50±1.30) mL, (8.56±2.04) mL, t=-3.582, P=0.003) and 1% sucrose preference percentage ( (51.35±8.69) %, (62.11±8.05) %, t=-2.576, P=0.022) of female pups in the model group were significantly lower than those in the control group. (3) The duration of immobility in tail suspension test ((126.95±39.89) s, (54.30±25.00) s, t=4.375, P=0.001) and forced swimming test ((7.97±6.66) s, (1.85±2.12) s, t=2.478, P=0.037) of female offspring in the model group were longer than those in the control group. (4) The expression of IGF-2 mRNA ((0.46±0.24), (1.00±0.00), t=3.821, P=0.019) and H19 mRNA ((0.60±0.25), (1.00±0.00), t=3.574, P=0.007) in hippocampus of female pups in the model group were lower than those of control group. The relative expression of IGF-2 protein in female offspring of model group was lower than that in control group ((0.77±0.04), (1.00±0.00), t=9.876, P=0.01). The relative expression of CCTC-binding factor (CTCF) mRNA ((1.29±0.12), (1.00±0.00), t=-4.850, P=0.003) and protein ((1.90±0.28), (1.00±0.00), t=-5.513, P=0.005) were higher than those in the control group. (5) The methylation levels of three CpG sites in the IGF-2 DMR region of female offspring in the model group were lower than those in the control group ( t=-3.21, -3.00, -3.34, all P<0.05), located at chr1215831028, chr1215831055 and chr1215831205, respectively. The methylation level of IGF-2 DMR fragment was lower than that of the control group ( t=-3.453, P=0.048). The relative expression levels of DNMT3A mRNA ( t=5.102, P=0.002), DNMT3A ( t=10.213, P<0.001) and DNMT3B ( t=4.169, P=0.014) in female offspring of the model group were lower than those in the control group. Conclusion:Chronic stress during pregnancy causes depression and despair in female offspring mice, and the mechanism may be related to the decrease of methylation level of imprinted gene IGF-2 DMR caused by the decrease of methyltransferase expression.

Objective To investigate the clinical effects and influencing factors of remote ischemic post-conditioning RIPostC in the patients with post stroke fatigue(PSF).Methods Eighty patients with PSF were ran-domly divided into experimental group(n = 40)and control group(n = 40).Patients in both groups received routine drug therapy and rehabilitation training for stroke.The experimental group were additionally given RIPostC for four weeks.They were evaluated with National Institute of Health Stroke Scale(NIHSS),Barthel Index(BI),Mini-mental State Examination(MMSE),fatigue severity scale(FSS),Hamilton Anxiety Scale(HAMA),and Hamilton Depression Scale(HAMD).Results The score of NIHSS,FSS,HAMA and HAMD in the both groups were decreased,while the score of BI and MMSE were increased(P<0.01).The difference in the score of NIHSS,BI,MMSE,FSS,HAMA and HAMD between the two groups before and after treatment showed statistical significance(P<0.01)and the difference in the score was more significant in the experimental group.The risk factors of FSS were MMSE and HAMA.Conclusion RIPostC can effectively improve the neurological deficits,daily activity ability and cog-nitive function,alleviate fatigue,anxiety and depression in the patients of PSF.The influencing factors of PSF are cognitive function and anxiety.

ObjectiveTo observe the effect of Kinesio taping on salivation after stroke. MethodsFrom October, 2019 to January, 2021, 40 patients with salivation after stroke were randomly divided into control group (n = 20) and experimental group (n = 20). Both groups received routine medicine, routine rehabilitation for dysphagia and rehabilitation nursing, while the experimental group received Kinesio taping in addition, for three weeks. They were assessed with Functional Oral Intake Scale (FOIS), Water Swallow Test (WST) and Teacher Drooling Scale (TDS) before and after treatment. ResultsOne case dropped in the experimental group. The scores of FOIS, TDS and WST improved in both groups after treatment (|Z| > 2.000, P < 0.05), and improved more in the experimental group than in the control group (|Z| > 3.045, P < 0.01). ConclusionKinesio taping may relieve the salivation of patients with dysphagia after stroke.