With the development of the neonatal intensive care technology,the livability of premature infants arises greatly.But the evidently increased handicap and unknowable prognosis have brought series of social problems.The author assumed that!abandoning or ending treatment of premature infants who have no social value after cure and who are about to die soon after born correspond to ethics principle.Hospital ethics committee should play role in the decision making of cure.

Inflammasome is a multi-protein complex which plays an important role in innate immune defense,and can adjust the activation of caspase-1 and promote the production of cytokines. NLRP3 is an important member of inflammasome Nod-like receptor(NLR)family,and its activation and expression occur mainly in macrophages and dendritic cells. NLRP3 can sense the pathogen associated molecular patterns(PAMPs)and damage associated molecular patterns(DAMPs)and initiate the inherent immune response,which plays an important role in the pathogenesis of autoimmune diseases. This article reviewed the advances in study on NLRP3 in autoimmune diseases.

Objective To preliminarily evaluate the performance and species specificity of Candida spp.latex immunochromatography kit for detecting Candida spp.in vaginal secretion.Methods The vaginal secretions in 354 cases of suspected vaginitis and 9 genus of 22 species of common vaginal infecting organisms were by adopting the smear/Gram staining and Candida spp.kit.The results were compared with those detected by smear/Gram staining semi-quantitative method.The detection performance and species specificity of Candida spp.kit for detecting clinical specimens were evaluated.Results Compared with the smear/Gram staining method,the sensitivity,specificity,accuracy,positive predictive value and negative predictive value of Candida sp.kit were 93.81%,99.10%,97.31%,98.14% and 96.90%,respectively;compared the smear/Gram staining semiquantitative method,the Candida spp.kit for detecting Candida spp.in vaginal secretion still had higher specificity and acceptable sensitivity when the Candida spp.concentration was lower in specimens;in the speciese specificity evaluation,6 kinds of Candida spp.were positive and other 16 kinds of common vaginal infecting organisms all were negative.Conclusion The Candida spp.kit for detecting Candida spp.in vaginal secretion has higher clinical and species specificity,sensivity,positive prediction value and negative prediction value.

Objective The immature platelet fraction (IPF) could be detected quantificationally in Sysmex XE-2100 with the software of XE-pro and IPF master.The study aimed to perform the methodological evaluation of IPF detection and investigate the clinical significance for the monitoring for bone marrow hyperplasia in cancer chemotherapy patients.Methods The high-level, middle-level and low-level whole blood samples were randomly chosen for detection repeatly 20 times to obtain interrun coefficient of variation (CV) for evaluation of the precision and reproducibility. Integrated quality controls were determined for continuous 20 days to obtain intrarun CV, and the stability and carryover was investigated.Furthermore, the correlation between results from Sysmex XE-2100 and results from flow cytometry was assessed.182 healthy subjects and 130 cancer patients undergoing chemotherapy were selected and the latter were divided into two groups according to platelet counts after therapy, one was normal PLT group, the other was decreased PLT group.The IPF of either group was measured and was compared with each other.Results The precision of IPF for high-level, middle-level and low-level were 4.71%, 4.33% and 4.95%, respectively, they were less than 5%.The interrun CV of IPF detection for middle-level and low-level were less than 5%.The interrun CV of IPF detection for high-level were less than 10%.The carryover ranged from 0.6% to 2.7%,and the average rate was 1.2%.A good correlation for IPF detection was shown between results from Sysmex XE-2100 and flow cytometry(r = 0.880 9,P ＜ 0.01).Regarding clinical utility of IPF detection in treatment monitoring for chemotherapy effect, the median of IPF levels in decreased PLT group, normal PLT group,control group were 14.45% ,7.35% and 15.68%, respectively.There was significant difference among the three groups (H =49.032,P ＜0.01 ).The IPF level was higher in decreased PLT group than normal PLT group (t = -5.681, P ＜ 0.O1 ), and was lower in normal PLT group after chemotherapy than the control group (t = -6.662 ,P ＜0.01 ).Conclusions The determination of IPF by the Sysmex XE-2100 owns high precision and good stability. IPF is an effective marker for evaluation of thrombopoietic condition in the cancer chemotherapy patients.

Objective:Population-based cancer registration data were used to analyze stomach cancer epidemiology in China. Meth-ods:Stomach cancer data were retrieved from the National Central Cancer Registry Database, and incident and death cases were esti-mated. The trend of stomach cancer was analyzed. Results:Approximately 424,000 new cancer cases and 298,000 cancer deaths oc-curred in China in 2012. The incidence and mortality rates of stomach cancer in urban males and females remained stable in 2000-2012, whereas the rates in rural males increased and less changes were observed in rural females. After age standardization, both inci-dence and mortality rates significantly decreased. The five-year age-standardized relative survival rate was 27.4% (95%CI: 26.7%-18.1%) in 2003-2005. Conclusion:Stomach cancer is a common cancer, which has heavy burden in China, particularly in rural areas. Ef-forts should be exerted for the prevention and control of the disease.

Objective To investigate medical students' cognitive status and attitude toward urban-rural integration and to find the influencing factors in an aim to provide information for the process of urban and rural integration.Methods Sampling survey was conducted among the junior students who were major in eight-year clinical medicine,five-year clinical medicine and nursing (undergraduate) with self-made questionnaire.The data entry was done by 19.0 SPSS software and descriptive statistical analysis and ONE-WAY ANOVA were used to do statistical analysis.Results Students who didn't know urban-rural integration accounted for 53.2％,while 80.7％ students supported urban-rural integration.Students' major and residence were two influencing factors of working in the countryside.Conclusion Measures should be taken to raise students' awareness of urban-rural integration based.Targeted measures should be adopted based on students' majors and residences.

Some questions like the hardship of treatment and lacking of standard on diagnosis are existing in steroid-resistant nephritic syndrome(SRNS).This article make an ethical analysis on these questions and assumes that we should persist in treating the patients carefully with humanism,carry on informed consent principle,implement the optimal treatment and perfect the standard of diagnosis and treatment,carry on clinical ethics education and promote the judgment level of clinical ethics.

Objective To estimate the critical value notification of emergency specimens in general laboratory whether a-chieved the desired goals,and to apply quality improvement measures to achieve quality improvement purposes.Methods Critical values of emergency specimens in general laboratory were monitored and collected in 2014.Statistical analysis was done for non-notification rates and sources of the critical values,and quality improvement began in July,2014 by training, continuing education and amonthly bulletin of notification data of critical values.Results Total number of Critical values of emergency specimens in general laboratory in 2014 was 2 648 and 1 950 of them had been reported by telephone.Total notifi-cation rate was 61.4% in the first 6 months,and was 81.4% from July to December.At last,Critical value notification rates increased to 97.72% in December.Conclusion Strengthening the management of critical value notification can help impro-ving the quality of laboratory service,as well as enhancing stuff responsibility and awareness of service for clinic.

Objective To analyze the changes of Blood Cell Count and D-dimer concentration in lung cancer patients with thrombosis.Methods ①554 cases of patients with lung cancer were included between January 2012 and November 2013,75 patients with other diseases which lead to high coagulation state were excluded,blood cell count and D-dimer concentration were compared between 64 lung cancer patients were the cases with thrombosis with 415 lung cancer patients were the con-trol group without thrombosis.②Color doppler ultrasonography was taken as the golden standard,receiver operating charac-teristic curves (ROC)were drawn for indexes which had significance in method.Results ①Compared with lung cancer pa-tients without thrombosis,lung cancer patients without thrombosis had decreased red blood cell count (RBC),increased white blood cell count (WBC)and D-dimer.And there were no significant change in platelet (PLT).②The area under curve (AUC)of ROC in RBC,WBC and D-dimer were 0.662,0.637 and 0.896,respectively.By thecut-off values of RBC>4.06× 1012 L,WBC<5.37×109/L and D-dimer<4.02 mg/L,the negative predictive values of RBC,WBC and D-dimer for diagno-sis of lung cancer patient with thrombosis were 93%,93% and 96%,respectively.By the cut-off value of D-dimer>4.02 mg/L,the positive predictive value of D-dimer for diagnosis of lung cancer patient with thrombosis was 6 6%.Conclusion RBC,WBC and D-dimer were related with the progress of thrombosis in lung cancer patients.RBC,WBC and D-dimer have good negative prediction effect on lung cancer patients with thrombosis.D-dimer had positive effect for diagnosis of lung cancer with thrombosis.

Objective To investigate the level of knowledge,attitude and practice(KAP)of pelvic floor dysfunction(PFD)and its influencing factors in pregnant women and provide reference for further health education for pregnant women. Methods Totally 637 pregnant women were investigated by Knowledge-Attitude-Practice (KAP)scale for PFD. Results The average scores of KAP in pregnant women were(31.68 ± 7.73),(16.41 ± 4.01) and (10.57 ± 3.00) respectively. About 85.6% of the pregnant women had interest in knowledge of PFD. Educational background,willing to understand knowledge of PFD,and gestational age were dominant factors affecting KAP of women with PFD. Conclusions The awareness rate of PFD and compliance rate of pelvic floor muscle function exercise in pregnant women are low. Effective measures should be taken to prevent PFD for pregnant women.