Objective To explore the mechanical ventilation in ICU patients with respiratory failure with pulmonary hypertension plasma brain natriuretic peptide (BNP) levels. Methods 50 patients needed mechanical ventilation with respiratory failure and pulmonary hypertension were randomly divided into two groups (each n = 25). On the basis of routine therapy, patients in noninvasive mechanical ventilation group received assistant breathing masks, and those in invasive mechanical ventilation group received tracheotomy or tracheal intubation. Blood gas analysis, plasma BNP levels, and pulmonary artery pressure before and 24 h after treatment were recorded. Results The arterial blood gas analysis index in the two groups 24 h after treatment were significantly improved (P < 0.05), especially in invasive mechanical ventilation group, so as the results of plasma BNP levels and pulmonary artery pressure (P < 0.05). Conclusions Invasive mechanical ventilation for ICU patients with respiratory failure and pulmonary hypertension is relatively better than noninvasive mechanical ventilation treatment. BNP concentration can be decreased by Mechanical ventilation, especially by invasive mechanical ventilation.

Objective To detect the distribution of H.pylori ureA, vacA s1 gene and cagA subtype(ABC, ABD, ABAB, AAD, et al) in patients with digestive diseases in Guangzhou and investigate the relationship with the pathological findings of gastric mucosa.Methods A total of 227 randomly selected gastric mucosa from patients with digestive diseases were enrolled in the research, including 46 without pathological changes, 130 with chronic gastritis, 29 with peptic ulcer, 15 with atrophic gastritis and 7 with gastric cancer.Real-time PCR assay were used to detect Helicobacter pylori ureA gene and vacA s1 gene.EPIYA motifs in the 3′ region of cagA were amplified by conventional PCR followed by subtype sequencing. The conserved gene ureA was used to detect H.pylori infection.Results Among the 227 patients with digestive diseases, 50.7% (115/227) patients were H.pylori positive, in which 91.3%(105/115) carried vacA s1 and 78.3% (90/115) carried cagA. Four types of cagA-EPIYA subtype were detected, including ABC 17.8%(16/90), ABD 78.9%(71/90), AAD 2.2%(2/90) and ABAB 1.1%(1/90).In the non-pathological change group, 32.6% (15/46) were H.pylori positive, in which 28.3% (13/46) carried vacA s1 and 26.1% (12/46) carried cagA;in chronic gastritis group, it was 48.5% (63/130), 43.8% (57/130) and 36.2% (47/130), respectively;in ulcer group, it was 72.4% (21/29), 65.5% (19/29) and 55.2% (16/29), respectively;in atrophic gastritis group, it was 66.7% (10/15), 66.7% (10/15) and 66.7% (10/15), respectively;in gastric cancer group, it was 85.7% (6/7), 85.7% (6/7) and 71.4% (5/7), respectively.The distribution of H.pylori among the 4 groups had statistical significance (χ2=16.72;P<0.01). H.pylori was more prevalent in ulcer, atrophic gastritis and cancer group than in inflammation group and non-pathological change group (χ2=16.02;P<0.01).In patients infected by H.pylori, there was no significant difference in the distribution of vacA s1 gene as high virulence factors among non-pathological change, inflammation, ulcer, atrophic gastritis and cancer group (χ2=2.00;P=0.74), as well as cagA (χ2=3.44;P=0.49) and EPIYA subtypes (χ2=3.66;P=0.45).Conclusions H.pylori infection is significantly associated with the pathological change of gastric mucosa for patients with digestive diseases in Guangzhou, while the relationship with the pathogenicity of H.pylori with high virulence genotype is not significant.More samples and diseases reclassification are needed to make an advanced analysis of the effect of H.pylori with high virulence in gastrointestinal diseases development.

Purpose　The aim is to sulfonize Hunai polysaccharide fr om p leurotus tuber-rigium(Fr.)Sing. and to evaluate the antioxidative activities of the sulfated po lysaccharide (S-HNP).Methods　S-HNP was prepared by the reacti on of Hunai polysaccharide with chlorosulfonic acid-Pyridine. The antioxidative activities o f S-HNP were evaluated as follows: (1) the inhibition effects on Fe2+- Vc inducing the injury of rat liver mitochondria in vitro, (2) the protectiv e ef fect on CuSO4 -Phen-Vc-H2O2 inducing the damage of DNA, (3) the scaven ging effect on O*-2. Results　 S-HNP could protect mitochondria from lipid peroxidation induced by Fe2+-Vc, i ncluding the inhibitions of the increase of TBARS content, the swelling of mitoc hondria and the decrease of membrane fluidity, and protect DNA from the damage induced by CuSO4-Phen-Vc-H2O2， and scavenge O*-2 generated in the sel f-oxidation of pyrogallic acid. Conclusion　S-HNP exhibi ted marked antioxidative activities.

This study aims to investigate the function of two SNPs (rs8904C > T and rs696G >A) in 3' untranslated region (3'UTR) of NFKBIA gene by constructing luciferase reporter gene. A patient's genomic DNA with rs8904 CC and rs696 GA genotype was used as the PCR template. Full-length 3'UTR of NFKBIA gene was amplified by different primers. After sequencing validation, these fragments were inserted to the luciferase reporter vector, pGL3-promoter to construct recombinant plasmids containing four kinds of haplotypes, pGL3-rs8904C/rs696G, pGL3-rs8904C/rs696A, pGL3-rs8904T/rs696G and pGL3-rs8904T/rs696A. Then these plasmids were transfected into LS174T cells and the luciferase activity was detected. Compared with pGL3-vector transfected cells (negative control), the luciferase activity of the four kinds of recombinant plasmids was significantly decreased (P < 0.001). For rs696G > A, the luciferase activity of the recombinant plasmids containing A allele (pGL3-rs8904C/rs696A and pGL3-rs8904T/rs696A) was about 45.1% (P < 0.05) and 56.1% (P < 0.001) lower than those containing G allele (pGL3-rs8904C/rs696G and pGL3-rs8904T/rs696G), respectively. For rs8904C > T, there were no significant differences in the luciferase activity between the recombinant plasmids containing T allele and those with C allele. Together, the luciferase reporter gene vectors containing SNPs in NFKBIA gene 3'UTR were constructed successfully and rs696G > A could decrease the luciferase activity while rs8904C >T didn't have much effect on the luciferase activity.

Objective To investigate the current status about the knowledge,attitude and practice of medical staff for fast-track surgery (FTS) in third-grade class-A general hospital in Xuzhou,and provide reference for the popularization of the FTS concept.Methods The self-administered questionnaires were employed to survey 130 medical staff in the general surgical department of one third-grade class-A general hospital in Xuzhou.Results The FTS knowledge score was (20±8).The differences of knowledge scores were statistically significant because of different age,degree of education and positional title.The FTS attitude score was (66±20).And the differences of attitude scores were statistically significant because of different age and degree of education.The FTS practice score was (64.50±13.25).There was no statistical significance on the practice scores between the medical staff with different characteristics.Attitude was correlated with knowledge and practice while knowledge was not correlated with practice.Conclusions The FTS knowledge of medical staff was not rich.The FTS attitude was not so positive,and there were also few clinical practice.Medical staff should study the FTS concept and its contents actively.They also should apply FTS in clinic scientifically in order to better control the iatrogenic injury and promote the rehabilitation of patients effectively.

Human resources are the core resources of a specialized hospital. The construction and management innovation of human resources are the key factors for the sustainable development of specialized hospitals. This article describes the practice of human resources management in our hospital in recent years, which makes full use of the good platform of grouping and unified management of provincial hospitals to formulate the 13th Five-Year Development Plan for Human Resources and improve corresponding measures. Through the recruitment, introduction, development and management innovation of human resources, our hospital is committed to perfecting the development of talents and disciplines, so that the enthusiasm and overall quality of the staff can be improved, the talent teams are unified, the structure is optimized, and the talent echelon gradually becomes reasonable. Our hospital will further implement the national new medical reform policy and strive to improve the capability of the specialty in our hospital, so as to meet the evergrowing medical needs of the general mass.

0. 05). Conclusions Tinnitus is a common problem in the older population. With the aging of population, the problem will become more and more severe. More research is urgently needed on prevention and treatment of tinnitus in elderly people.

Objective To explore the impact of postpartum fatigue on the onset of lactation.Methods Totally 553 mother-infant dyads were enrolled from three hospitals in Nantong City using sampling method of probability proportional to size.The timing of the onset of lactation,delayed onset of lactation and maternal postpartum fatigue were measured during the period of hospitalization.Postpartum fatigue was measured by Fatigue Scale-14.The timing of onset of lactation was determined by matemal perception of breast fullness.One-way analysis of variance was used to compare the difference of onset of lactation in four groups with varied fatigue scores.Impact of the maternal fatigue on the onset of lactation was analyzed by multiple linear regression.Results Mothers' fatigue score was related to the onset of lactation(r-0.15,P＜0.001).Mothers with postpartum fatigue scores ranging from 9 to 14 had delayed onset of lactation compared with those with fatigue score ranging from 0 to 3 and from 4 to 5,and the differences were significant (P=0.004),and the rate of delayed onset of lactation was increased (P=0.020).Postpartum fatigue was an independent risk factor,after controlling mode of delivery,mode of anesthesia,duration of infant sucking,maternal pain,and infant sucking gesture(t=3.26,P=0.001).Conclusion Postpartum fatigue is one of reasons leading to delayed onset of lactation.Health care providers and family members should pay more attention to postpartum fatigue and take effective measures to promote a successful onset of lactation and breastfeeding.

Objective To analyze clinical characteristics of severe community-acquired pneumonia during pregnancy and its outcomes, and to explore the relevant risk factors. Methods From September 2012 to September 2017,324 398 pregnancies admitted in 7 tertiary hospitals were included. Clinical data of 33 cases of pregnancies with severe community-acquired pneumonia(severe pneumonia group)and 214 cases of pregnancies with common community-acquired pneumonia (control group) were reviewed retrospectively, including the clinical information, manifestations, laboratory examinations and pregnancy outcomes. Relevant risk factors were analyzed by multivariate logistic regression analysis. Results (1) General data: pregnancies with severe community-acquired pneumonia accounted for 0.010%(33/324 398) of hospitalized pregnancies, the gestational age of two groups were(28±8)and(23±8)weeks, body mass index were(21.7±2.1)and(25.5±3.4)kg/m2, rate of low income were 54.5%(18/33)and 31.8%(68/214), respectively. The differences between two groups were all statistically significant(all P<0.05). No significant differences were found in age, pregnancy and parity times, rate of main pregnant complications such as diabetes and hypertension, educational level, asthma and onset seasons between two groups(all P>0.05). (2)Clinical data: the severe pneumonia group had significantly higher incidence of fever [100.0%(33/33)vs 75.2%(161/214)], shortness of breath(90.9% vs 16.8%)compared with the control group(all P<0.05).The median peripheral leukocytes counts were 12.3×109/L and 10.2×109/L, the hemoglobin level were(84±18) and(107±14)g/L,the albumin level were(26±4)and(37±3)g/L, the median serum urea nitrogen level were 3.7 and 2.4 mmol/L,the serum creatinine level were(72±25)and(45±11)μmol/L, respectively in two groups. The differences were all statistically significant (all P<0.05). No significantly statistical differences were found in coagulation indicator and cardiac function between two groups(all P>0.05).(3) Treatments: in severe pneumonia group, 12 patients(36.4%,12/33)needed invasive mechanical ventilation, 9 patients(27.3%,9/33)needed non-invasive mechanical ventilation, average time of mechanical ventilation was(7±4)days;8 patients(24.2%,8/33)with septic shock needed vasoactive drugs. However, there was no patient in control group needing mechanical ventilation and vasoactive drugs.(4)Pregnant outcomes: one patient(3.0%,1/33)died in the severe pneumonia group, while no death occurred in the control group. The hospital stay between two groups were(15.1±4.1)and(7.0±1.9)days, the rates of abortion and stillbirth between two groups were 42.4%(14/33)and 3.3%(7/214), the rates of premature were 10/19 and 6.3% (13/207), the rates of cesarean were 15/19 and 43.0%(89/207), the rates of low birth weight newborn were 17/19 and 14.0%(29/207), the rates of infected newborn were 15/19 and 10.1%(21/207), the birth weights were(2 165±681)and(3 102±400)g, respectively. The differences between two groups were all statistically significant(all P<0.05).(5)Multivariate logistic regression analysis demonstrated that anemia, low body mass index, hypoproteinemia were risk factors for severe pneumonia in pregnancy(all P<0.05). Conclusions Pregnancy with severe community-acquired pneumonia may be complicated by multiple organ dysfunctions, lead to adverse outcomes. Anemia, malnutrition are risk factors for pregnancy with severe pneumonia. Active and effective treatment may improve its prognosis.

{L-End}Objective To investigate the current status of long working hours of food-delivery workers from food-delivery platform, and analyze its impact on their health such as occupational stress, depressive symptoms, insomnia symptoms, fatigue accumulation, and life satisfaction. {L-End}Methods A total of 2 145 food-delivery workers from two food-delivery platforms in Guangzhou City were selected as the research subjects using convenience sampling method. The occupational stress, depressive symptoms, insomnia symptoms, fatigue accumulation, and life satisfaction were investigated using the Core Occupational Stress Scale, Patient Health Questionnaire-9 items, Self-sleep Management Questionnaire, Self-diagnosis Questionnaire of Fatigue Accumulation of Workers, and World Health Organization Five-item Well Being Index. {L-End}Results The median and the 25th and 75th percentiles of weekly working hours were 63 (49,77) hours. And 92.2% (1 978/2 145) of workers, who worked more than 40 hours per week, were long working hours workers. While 70.1% (1 504/2 145) workers, who worked 55 hours or more per week, were ultra-long working hours workers. The detection rate of occupational stress, depressive symptoms, insomnia symptoms, fatigue accumulation, and low life satisfaction was 30.1%, 27.5%, 34.7%, 40.8%, and 75.1%, respectively. The longer the weekly working hours of the research subjects, the higher the detection rate of occupational stress and fatigue accumulation (all P<0.01). The results of multivariate logistic regression analysis showed that ultra-long working hours (weekly working hours ≥55 hours) was the influencing factor of occupational stress and fatigue accumulation after excluding the influence of confounding factors among workers (all P<0.05). {L-End}Conclusion The food-delivery workers of food-delivery platforms generally work long hours. Ultra-long working hours is a risk factor for occupational stress and fatigue accumulation among these workers.