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.

Background Job burnout and depressive symptoms are prevalent among occupational populations, with a close relationship between them. Sleep quality, as a potential mediating factor, significantly affects the mental health of workers. Objective To explore the relationship between job burnout, sleep quality, and depressive symptoms, and determine whether sleep quality mediates the relationship between job burnout and depressive symptoms. Methods From April 25 to May 1, 2024, this study employed cluster sampling to conduct a questionnaire survey among individuals engaged in various occupations across five cities in the Ningxia Hui Autonomous Region. The questionnaires included socio-demographic information, as well as the Chinese Maslach Burnout Inventory (CMBI), the Pittsburgh Sleep Quality Index (PSQI), and the Patient Health Questionnaire-9 (PHQ-9) for assessing burnout, sleep quality, and depressive symptoms, respectively. Out of the 4106 questionnaires distributed, a total of 3837 questionnaires were valid, and the valid recovery rate was 93.45%. The distribution among demographic variables in burnout, sleep quality and depressive symptoms were statistically analyzed. A binary logistic regression model was used for multifactor correlation analysis; Pearson correlation was used to test the correlation between burnout, sleep quality, and depressed mood. Modelling and mediated effect path mapping were performed using Amos 24.0 software. Results The postive rate of occupational burnout in the workers was 97.49% (3741/3837), the positive rate of poor sleep quality was 66.77% (2526/3837), and the positive rate of depressive symptoms was 75.68% (2904/3837). There were statistically significant differences in depressive symptoms by ages, shift types, working years, marital status, smoking habits, drinking habits, and exercising frequency (P < 0.05). The logistic model indicated that working years, drinking habits, job burnout, and overall sleep quality were significant factors influencing the occurrence of depressive symptoms (P < 0.05). The correlation analysis revealed positive correlations between depressive symptom scores and job burnout scores (r=0.045, P < 0.01), between depressive symptom scores and sleep quality scores (r=0.480, P < 0.01), and between job burnout scores and sleep quality scores (r=0.054, P < 0.01). Furthermore, the indirect effect of job burnout on depressive symptoms through sleep quality was 0.100 (95%CI: 0.204, 0.252; P < 0.01). Conclusion Job burnout and sleep quality are significant factors associated with the occurrence of depressive symptoms among occupational populations, and sleep quality plays a partial mediating role in depressive symptoms associated with job burnout. This finding may provide a scientific basis for developing intervention strategies to control depressive symptoms among workers.

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 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.

Background During pregnancy, negative emotions such as anxiety and depression may induce cortisol disruption. Cortisol can be transmitted to the fetus through the placental barrier, thereby affecting the neurodevelopment of the offspring. Objective To investigate the relationship between placental cortisol, maternal depression during pregnancy, and neurodevelopment of 3-month-old infants. Methods From September 2022 to September 2023, 171 pregnant women ordered routine prenatal checks at the obstetrics outpatient department of a tertiary hospital in Ningxia were selected using a prospective cohort design. After providing informed consent, these women participated in a questionnaire survey that covered general individual characteristics, prenatal depression, and sleep quality. At birth, placental samples were collected to measure cortisol levels using ELISA kits. Follow-up assessments on the neurodevelopmental of 3-month-old infants were conducted using the Warning Sign for Children Mental and Behavioral Development. LASSO regression analysis was conducted to screen the influencing factors of depression during pregnancy. Huber regression analysis was then applied to assess potential linear relationship between depression during pregnancy and placental cortisol levels. Log-binomial regression was used to analyze the linear relationships between cortisol levels and neurodevelopmental delay in 3-month-old infants. Additionally, a mediation effect model was fitted using R 4.3.3 to assess possible mediating role of cortisol in the association between prenatal depression and neurodevelopmental delay in 3-month-old infants. Results The positive rate of prenatal depression was 33.33%. Nine factors affecting prenatal depression were identified by LASSO regression, including rural residence, high school education or above, extroverted personality characteristics, moderate early pregnancy reactions, baby sex expectation, prenatal anxiety, family dysfunction, exposure to stressful life events during pregnancy, and moderate prenatal sleep quality. The Huber regression model showed a positive linear correlation between prenatal depression and placental cortisol (P<0.05). With or without controlling confounding factors, the results of log-binomial regression modeling showed that cortisol levels were associated with a reduced risk of neurodevelopmental delay in 3-month-old infants (crude model: RR=0.988, 95%CI: 0.9768, 0.9996, P＜0.05; adjusted model: RR=0.988, 95%CI: 0.9764, 0.9993, P＜0.05). A mediating effect of placental cortisol between prenatal depression and the risk of neurodevelopmental delay in 3-month-old offspring was found statistically significant (P=0.045), accounting for 67.0% of the total effect. Conclusion Prenatal depression is associated with elevated placental cortisol levels, and higher cortisol levels are found to be related to a lower risk of neurodevelopmental delay in infants. Placental cortisol mediates the relationship between prenatal depression and infant neurodevelopment.

Background Prenatal chronic psychological stress may increase the risk of allergic diseases in children, and eczema is the most common allergic disease in children, the pathogenesis of which is not yet fully understood. Objective To preliminarily clarify the changes in offspring intestinal flora after chronic stress exposure during pregnancy in rats that increases offspring immune imbalance and eczema susceptibility. Methods Thirty SPF-grade adult female SD rats were selected and randomly divided into a model group and a control group (n=15). Sixteen male rats were randomly divided into a model mating group and a control mating group (n=8). A 28-day chronic unpredictable mild stress (CUMS) model during pregnancy was established. On the 7th day of stress, male and female rats were caged in a ratio of 3:1. Blood samples were collected from female rats in each group via angular vein on the 1st day before stress, and on the 7th, 14th, 21st, and 28th days after stress. The content of plasma corticosterone during pregnancy was determined by enzyme-linked immunosorbent assay (ELISA). For the offspring rats, an eczema model was constructed using 2,4-dinitrochlorobenzene (DNCB). The number of scratching times of the offspring rats within 5 min was recorded. The offspring rats were divided into 4 groups: DNCB-CUMS group (MM), DNCB-control group (MC), solvent control-CUMS group (CM), and blank control group (CC), with 8 rats in each group. The eczema was induced once every 3 days, and the induction period was 12 d. The expression level of immunoglobulin E (IgE) in the serum of offspring rats after the eczema induction experiment were determined by ELISA. The concentrations of tumor necrosis factor-α (TNF-α), interferon-γ (IFN-γ), interleukin-2 (IL-2), interleukin-4 (IL-4), and interleukin-13 (IL-13) in the serum were quantified by multi-parameter flow cytometry. The composition and abundance of intestinal microbiota in the feces of offspring rats were detected by 16S rRNA high-throughput sequencing technology. Results The plasma corticosterone concentrations in the model group were higher than those in the control group on the 7th and 21st days of stress (P<0.05). On the 14th and 21st days of stress, the 1% sucrose preference percentages of female rats in the model group were lower than that in the control group. On the 7th, 14th, and 21st days of stress, the horizontal movement scores of female rats in the model group and the vertical movement scores on the 7th and 14th days were lower than those in the control group (P<0.05). After 6, 9, and 12 d of model building, the scratching frequencies in the MC group and MM group were significantly higher than those in the CC group and CM group (P<0.05). Moreover, there were differences in the contents of cytokines including IFN-γ, IL-2, TNF-α, IL-4, IL-13, and IgE among the offspring rat groups (P<0.05). The CM group and MM group led to an increase in the contents of TNF-α, IL-4, IL-13, and IgE cytokines (P<0.05), while the MM group caused a decrease in the contents of IFN-γ and IL-2 (P<0.05). After the eczema induction experiment, the α-diversity analysis showed that the Simpson index and Shannon index in the CM were higher than those in the CC (P<0.05), indicating that CUMS during the pregnancy of female rats could increase the species abundance of their offspring. The abundances of Prevotella and Lactobacillus in the CM group decreased (P<0.05). Conclusion Intestinal dysbiosis in offspring due to chronic prenatal psychological stress, which may be one of the mechanisms linking maternal stress to immune imbalance and increased susceptibility to eczema in offspring.