Objective: To explore the relationship between platelet counts at admission and in-hospital mortality in patients with type A acute aortic dissection (AAD). Methods: We investigated 183 consecutive patients with CT conifrmed diagnosis of type A AAD treated in our hospital from 2012-02 to 2013-05. There were 126 (68.9%) male and the patients were divided into 3 sets of groups.①In-hospital surviving group,n=157 and In-hospital death group,n=26.②According to platelet counts, the patients were divided into 5 groups: Q1 group, platelet counts ≤ 119×109/L,n=36, Q2 group, platelet (120-149) ×109/L,n=37, Q3 group, platelet (150-173)×109/L, n=36, Q4 group, platelet (174-228)×109/L,n=37, Q5 group, platelet >228×109/L,n=37.③At admission, platelet ≤ 119×109/L,n=36 and platelet >119×109/L,n=147. In addition, the patients were further divided into another 4 groups based on operative condition: platelet ≤ 119×109/L with operation,n=18, without operation,n=18; platelet > 119×109/L with operation,n=96, without operation,n=51. The basic information at admission including platelet counts, WBC and D-dimer were studied in all groups, the primary endpoint was in-hospital mortality. Results: The overall in-hospital mortality was 14.3%. Compared with In-hospital surviving group, the In-hospital mortality group had decreased platelet counts, lower blood pressure and higher level of D-dimer. The mortality in Q1 group (38.9%) was higher than those in Q2, Q3, Q4 and Q5 groups (10.8%, 11.1%, 8.1% and 2.7%), allP<0.001. The risk of death in Q5 group was higher than Q1 group (HR=11.2, 95% CI 2.13-123.3,P=0.007). With adjusted age, gender and other relevant factors, when platelet counts ≤ 119×109/L, the risk of in-hospital mortality with Cox multivariate model I analysis was (HR3.90, 95% CI 1.67-9.09,P=0.002), with Cox model II was (HR=2.67, 95% CI 1.15 -6.19,P=0.023). Conclusion: AAD patients with admission platelet counts ≤ 119×109/L had the high risk of in-hospital death, even with operation, lower platelet counts was still related to in-hospital death.

Objective To investigate the status of nursing professional values and its influencing factors to make contribution for nursing managers to improve nursing professional values.Methods 280 registered nurses selected by convenient sampling method were investigated by demographic questionnaires and the Revised Nursing Professional Values Scale (NPVS-R).Results The score of nursing professional value was (100.70 ± 6.36) points,the highest scoring dimension wasprofessional characteristic ,followed by trust, behavioristand providing care.The scores of protecting patients privacy,being trusted by patients,constantly improving professional ability,etc.were higher.The scores of involving in research,peer review and public decision,etc.were lower.Medical department,profession and interest,job satisfaction were the influencing factors,F values were 2.575,3.750 and 2.909.Conclusions The nursing professional value was higher than middle level and unbalanced development.Nursing managers should take individualized approach to improve nursing professional values based on the characteristics of departments and lower score parts.

To explore the clinical features and common complications of fast resting heart rate (RHR) in hypertensionpatients. Methods: We retrospectively analyzed the entire rest electrocardiogram data of Qingdao study 2000 and Xinyang study2005 in community population elder than 18 years including hypertension patients and non-hypertension subjects. Clinical complications as diabetes, coronary artery disease, hyperlipidemia and stroke, laboratory findings, RHR in ECG, body mass index (BMI), waist to hip ratio and office blood pressure were collected in all participants. Results: A total of 18183 participants were enrolled including 61.6% male, the average age was (45.2±12.7) years including 6763 hypertension patients. Compared with normal BP subjects, hypertension patients had the faster RHR (73.5±11.6) times/min vs (70.6±9.6) times/min, P<0.001 and more hypertension patients combining fast RHR (14.5% vs 6.4%), P<0.001. In hypertension patients, compared with normal RHR patients, fast RHR patients had the elder age (53.9±12.2) years vs (51.8±11.2) years, lower BMI (25.8±3.6) kg/m2 vs (26.4±3.4) kg/m2 and higher ratio of grade 3 hypertension (68.2%vs 59.0%), all P<0.001; higher levels of fasting blood glucose (6.0±2.4) mmol/L vs (5.6±1.5) mmol/L and triglyceride (2.0±1.8) mmol/L vs (1.7±1.3) mmol/L, both P<0.001, higher LDL-C (3.2±0.9) mmol/L vs (3.1±0.8) mmol/L, P=0.001;more patients with diabetes (6.6% vs 3.9%), P=0.007 and stroke (11.1% vs 8.3%), P=0.005. Multivariate regression analysis indicated that with adjusted traditional risk factors, fast RHR was positively related to stroke occurrence in hypertension patients (OR=1.306, 95% CI 1.021-1.671). Conclusion: Fast RHR happened more in hypertension patients than in normal BP subjects; it had the increased risk for stroke occurrence in hypertension patients.

Objective To search one ultrasonic method which could evaluate gastric emptying function accurately.Methods The gastric emptying time of 74 normal volunteers were measured by radioisotope scanning and different ultrasonic methods which including gastric antrum area,gastric antrum volume and whole gastric cylinder method.Results The gastric emptying time measured by whole gastric cylinder method related best with those measured by radioisotope scanning (r =0.79).The gastric emptying time was no significant difference between the cylinder method and radionuclide scanning (P ＞0.05).Compared with radionuclide scanning,those measured by gastric antrum area and gastric antrum volume had significant differences.Conclusions The whole gastric cylinder method can accurately reflect the gastric emptying function.

Objective To evaluate the clinical value of determination of composition of kidney stones by shap and density and of prediction of the efficacy of extracorporeal shock-wave lithotripsy (ESWL) by X-rays. Methods The data of 358 patients were analyzed,with 204 male and 154 female and with 276 cases of solitary stones and 82 cases of multiple stones.Determine the composition of kidney stones by shap and density,predict the efficacy of ESWL by X-rays,and choose the appropriate method of treatment.Analyze stone chemical property by Infrared stone composition automatic analyzer to checkout the prediction results before surgeries. Results 339 cases were successful to remove stones after treatment.The prediction results of 308 cases (86.0％) were consistent in stone chemical property,and the preperative prediction results of 339 cases (94.7％) were consistent in ESWL efficacy. Conclusions Determination of composition of kidney stones and prediction of the efficacy of ESWL by X-rays were feasible.

Objective To explore the significance in judging the different clinical stages of relapsing polychondritis (RP) patients through examining the changes of aggrecanase and metabolic fragments of aggrecan.MethodsIn comparison with the control group (20 cases),40 patients were divided into the stable stage group (22 cases) and the active stage group (18 cases).The aggrecanase-generated neoeptitopes in cartilage matrix were analysed by immunohistochemistry and Western blot(WB) respectively.The mRNA and protein levels of aggrecanase-1,2 expressed in cartilage cells were measured by real-time reverse transcriptional polymerase chain reaction(RT-PCR) and WB respectively.The difference of these results among these three groups was analyzed accordingly.ResultsThe expression of aggrecanase-1,2 in mRNA level was measured by real-time RT-PCR.The values of aggrecanase-1,2 mRNA 2 -ΔΔC1 were 1.00 ± 0.26 and 1.00 ± 0.27 in control group,1.47 ± 0.11 and 1.57 ± 0.13 in stable stage group,2.09 ±0.12 and 2.09 ± 0.19 in active stage group respectively.By one-way ANOVA analysis,the difference between every two groups was statistically significant (F was 299.113 and 459.013,P ＜ 0.01 ).In comparison with control group,aggrecanase-1,2 increased significantly in both stable and active stage group (P ＜ 0.01 ) and aggrecanase-1,2 increased more significantly in active stage group than in stable stage group (P ＜ 0.01 ).The results from WB analysis indicated that aggrecanase-1,2 could not be detected in control group,and they were detectable in stable stage group and increased in active stage group at the relative molecular of 68 000 Da or 73 000 Da respectively.The aggrecanase-generated neoeptitopes were analyzed by WB as well.The results indicated that NITEGE and ARGSV could be detected in stable stage group and increased in active stage group at the relative molecular of 70 000 Da or 48 000 Da respectively,but there were no signals in control group.Similar with the previous WB results,no signals of NITEGE or ARGSV eptitopes were detected in normal cartilage matrix ( no red staining) by use of immunohistochemical staining.However,in stable stage group and active stage group,these eptitopes were apparently detected (obviously red staining).ConclusionWith the progression of the RP,the activity of the aggrecanase is enhanced,and the degradation of the aggrecan is increased,associated with the severity of the disease.

Objective To investigate the current staffing of nurses and need of hospital nursing human resources in China.Methods Data were collected from 181 secondary and tertiary hospitals and 9774 nurses in mainland China by questionnaires.Results The average doctor-nurse ratio was 1 ∶ 1.39 in tertiary hospitals and 1 ∶ 1.31 in secondary hospitals.The doctor-nurse ratios in 164 hospitals (97.6％) and the proportion of nurses in health care staff in 105 hospitals (61.8％) had not reached the standard set by the Ministry of Health of China.62.3％ nurses held secondary diploma for their initial nursing education.The constituent ratio of nurses held secondary diploma decreased,while the ratio of nurses held advanced diploma and bachelor degree increased in the last 5 years from 2003 to 2007.Sixty percent of newly employed nurses were contract nurses in 2003.The proportion increased to 78％ in 2007,and in some regions it accounted for more than 90％ of new nurses.The needs and constituent ratio of nurses with.secondary diploma and advanced diploma would decrease while nurses with bachelor degree and master degree would increase in the next 5 years (from 2009 to 2013).Conclusions The nursing shortage is still severe in China,and nursing staff mainly held secondary diploma for their initial nursing education.Most of new nurses were employed as conwact nurses.The need of hospitals for nurses has increased,especially for nurses with higher educational level such as bachelor degree and master degree,while the need for secondary diploma hold ers have decreased.The need for advanced diploma holders has increased in the last 5 years and would decrease in the next 5 years,but they would still be the majority of employed nurses.The authors suggested that the staffing of nursing manpower,the work environments and career development of contract nurses should be improved,and the initial nursing education should be upgraded to meet the needs of hospitals.

OBJECTIVETo investigate the role of matrix metalloproteinase-7 (MMP-7) expression in caricinogenesis and progression of gastric cancer.

METHODSWe studied MMP-7 expression and microvessel density (MVD) in adjacent mucosa and primary foci of 113 cases of gastric cancer by streptavidin-biotin-immunoperoxidase method using anti-MMP-7 and anti-CD34 antibodies. MMP-7 expression and mean MVD were compared with clinicopathological features of gastric cancer, with the relationship between MMP-7 expression and MVD concerned in gastric cancer.

RESULTSMMP-7 showed positive expression in adjacent mucosa of gastric cancer (29.20%, 33/113), less than that in gastric cancer (69.03%, 78/113). MMP-7 expression in primary foci of gastric cancer was positively correlated with tumor size, invasive depth, metastasis and TNM staging (P<0.05), but not with differentiation or growth pattern of gastric cancer (P>0.05). Positive correlation of mean MVD with tumor size, invasive depth, metastasis and TNM staging was found (P<0.05), despite no relationship between mean MVD and differentiation of gastric cancer (P>0.05). Mean MVD was dependent on MMP-7 expression in gastric cancer (P<0.05).

CONCLUSIONUpregulated expression of MMP-7 played an important role in carcinogenesis and progression by participating in growth, invasion, metastasis and angiogenesis of gastric cancer. MMP-7 expression could be regarded as an effective and objective marker to reflect the biological behaviors of gastric cancer.

Biomarkers, Tumor ; metabolism ; Humans ; Lymphatic Metastasis ; Matrix Metalloproteinase 7 ; metabolism ; Neoplasm Invasiveness ; Neoplasm Staging ; Neovascularization, Pathologic ; pathology ; Stomach Neoplasms ; blood supply ; metabolism ; pathology

Objective:To compare the efficacy of three different surgical methods in the treatment of patients with pelvic organ prolapse (POP)-Q grade Ⅱ-Ⅲ uterine prolapse (UP).Methods:The clinical data of 100 patients with pelvic organ prolapse quantitative (POP-Q) grade Ⅱ-Ⅲ UP treated in the First Affiliated Hospital of Medical College of Shihezi University from November 2015 to April 2019 were analyzed retrospectively. According to the operation method, they were divided into vaginal total hysterectomy group (TVH group, n=46), laparoscopic total hysterectomy + vaginal stump Y-patch sacral fixation group (LSC group, n=34) and transabdominal total hysterectomy + vaginal stump abdominal transverse fascia and round ligament suspension group (AFS group, n=20). The age, body mass index, delivery times, operation time and intraoperative bleeding of the three groups were compared. POP-Q scale, visual analogue scale (VAS) and Pelvic Floor Impact Questionnaire (PFIQ-7) were used to evaluate the objective cure, subjective satisfaction, preoperative and postoperative quality of life, and the recurrence rate of postoperative prolapse was compared. Results:Among the three groups, the TVH group had the shortest operation time and the LSC group had the least intraoperative blood loss ( P<0.05). The postoperative PFIQ-7 score improved the quality of life in the AFS group significantly better than the other two groups ( P<0.05). The postoperative POP-Q indicator points of the three groups were significantly improved than before ( P<0.05). Postoperative prolapse recurred in 8 cases (17.4%) in TVH group, 3 cases (8.8%) in LSC group and 1 case (5.0%) in AFS group, with no significant difference in recurrence rate among the three groups ( P>0.05). Conclusions:These three surgical treatments are all safe and effective for the treatment of moderate to severe uterine prolapse. Various factors should be considered comprehensively to develop individualized surgical plans for patients.

Objective:To explore the experience of self-management dilemma ofadults with emerging ankylosing spondylitis, and to provide reference for the construction of self-management intervention strategies for emerging adults with ankylosing spondylitis.Methods:Descriptive phenomenology was used to conduct in-depth interviews with 14 adults with emerging ankylosing spondylitis in the Rheumatology and Immunology Department of Drum Tower Hospital Affiliated to Medical College of Nanjing University from August 2022 to March 2023. The interview data were analyzed by Colaizzi′s seven-step analysis method.Results:A total of 14 patients completed the interview,10 males, 4 females, aged 21-30 years. In adults with emerging ankylosing spondylitis, there were dilemmas of role maladjustment and disease management disorder, including role maladjustment of disease management and social role maladjustment. Barriers to disease management included weak self-management awareness, insufficient support for self-management information, inadequate self-management skills, and poor compliance with self-management behaviors.Conclusions:The role adaptation and self-management ability of adults with emerging ankylosing spondylitis are seriously inadequate. It is urgent to construct health management strategies for adults with emerging ankylosing spondylitis to help them improve the level of role adaptation and disease management.