Objective To investigate the relationship between serum levels of PCT and neutrophil CD64 contents with the effect of hormone therapy and complications in the patients with primary nephrotic syndrome.Methods Sixty-five patients with primary nephrotic syndrome in our hospital from September 2015 to September 2016 were selected as the research subjects,all cases were treated with hormonal therapy,the serum levels of PCT and neutrophil CD64 were detected and their relationship with the curative effect and complications of nephrotic syndrome was analyzed.Results According to the PCT and neutrophil CD64 median levels,the cases were divided into the high level group and low level group,the results found that serum creatinine,serum protein,urine protein and pathological types had no statistical difference between the high level group and low level group.The hormone sensitivity had 15 cases in the patients with high PCT level,which was significantly lower than 21 cases in the patients with low PCT level;the hormone sensitivity had 14 cases in the patients with high neutrophil CD64 level,acute renal failure,infection and thrombus in the patients with high PCT level had 8,10,6 cases,which were significantly lower than those in the patients with low PCT level;acute renal failure,infection and thrombus in the patients with high neutrophil CD64 level had 7,11,6 cases,which were significantly higher than those in the patients with low neutrophil CD64 level (P<0.05).Conclusion The levels of serum PCT and neutrophil CD64 are significantly correlated with the therapeutic effect and clinical prognosis in the patients with nephrotic syndrome.

Objective To investigate the risk factors associated with early mortality (within 30 days) of patients with spontaneously ruptured hepatocellular carcinoma (SRHCC) and assess the efficacies of different treatment regimens. Methods The clinical data of 28 patients with SRHCC who had been admitted to our hospital from January 1999 to January 2006 were retrospectively analyzed. Multiple factors that might cause early mortality were determined, and the efficacies of different treatment regimens were assessed. Results Eleven patients died within 30 days. with the mortality rate of 39%. Univariate analysis showed that shock, Child C status, hemoglobin. ALT, and volume of blood transfusion were associated with early mortality (X2=3.020, 13.741, Z=-2.059, -2.210, -4.153, P<0.05). Child C status and volume of blood transfusion were the independent risk factors. All the patients were divided into hepatectomy group (8 cases), surgical hemostasis group (7 cases), transarterial embolization group (7 cases) and conservative group (6 cases). Patients in hepatectomy group had a better 30-day and median time survival rate compared with those in the other 3 groups (X2=8.098, 8.098, 15.025, Z=-3.127, -2.840, -3.004, P<0.05). Conclusions Poor hepatic functional reserve and severe hemorrhage are closely associated with early mortality of patients with SRHCC. Hepatectomy is a better choice for SRHCC.

Objective To assess the value of magnetic resonance angiography (MRA) and arterial proton spin labeling (ASL) in the internal carotid artery transient ischemic attack. Methods According to TIA seizure frequency, 58 patients clinical diagnosed as TIA were divided into single group (n=12) and the frequent group (n=46). All patients underwent MRA and ASL, then intracranial arterial stenosis and cerebral perfusion were evaluated. Results Vascular stenosis with abnormal ASL were detected in 33 (71.74%) of 46 frequent TIA patients and 1 (8.33%) single TIA patient. The incidence of vascular stenosis with abnormal ASL was higher in frequent TIA than that in single TIA (P＜0.05). Conclusion Vascular stenosis with perfusion abnormality is one of the most risk factors of TIA frequent seizures. Combination of MRA and ASL can make judgment for stenosis and abnormality of cerebral blood flow, being helpful to understand the onset causes and prognosis of TIA.

Objective To evaluate the clinical efficacy of early enteral nutrition combined with additional parenteral nutrition (EEN + PN) versus TPN (total parenteral nutrition) in patients after conventional pancreaticoduodenectomy (PD).Methods From January 2009 to January 2013, 340 consecutive patients who underwent conventional PD with Child's reconstruction at the First Affiliated Hospital of Xi'an Jiaotong University were enrolled into this single-center retrospective comparative study.There were 87 patients in the EEN + PN group and 253 patients in the TPN group.The preoperative baseline characteristics,histopathological types, intraoperative parameters and postoperative outcomes were recorded and compared between the two groups.Results There were no significant differences in the preoperative general characteristics data, pathological patterns, and intraoperative details.There were significantly higher rates in delayed gastric emptying (DGE), morbidity (15.9％ vs 6.7％, P ＜ 0.05), and pneumonia (10.3％ vs 3.6％, P ＜ 0.05);significantly prolonged nasogastric tube removal time (5.6 ± 0.2 days vs 3.9 ± 0.1 days, P＜0.05), and increase in hospitalization expenses (65 397.0 ± 861.2) Yuan vs (50 663.9 ± 239.2) Yuan, P ＜ 0.05) in the EEN + PN group when compared with the TPN group.Conclusions EEN + PN after conventional PD was associated with increased rates of DGE and pneumonia, prolonged nasogastric tube removal time, longer EN duration and increase in hospitalization expenses.Hence, EEN should only be performed prudently and selectively.

Objective:To explore the changes and clinical significance of serum amyloid A (SAA)level in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) .Methods:A total of 140 patients with AECOPD ,80 patients with stable stage COPD and 40 health controls during Jun .2012 and Dec .2013 were collected .The serum levels of SAA ,C‐reactive protein(CRP) ,tumor necrosis factor‐α(TNF‐α) and interleukin‐8 (IL‐8) were measured .Results:The serum levels of SAA ,CRP ,TNF‐α and IL‐8 in all patients with COPD were significantly higher than those in the controls (P<0 .05) .The serum levels of SAA ,CRP ,TNF‐α and IL‐8 in patients with AECOPD were significantly higher than those in patients with stable stage COPD(P<005) .SAA level was significantly correlated with TNF‐α level and IL‐8 level(r=0 .78 , r=0 .69 ,P<0 .01) .Serum CRP level was also significantly correlated with TNF‐αlevel and IL‐8 level(r=0 .68 ,r=0 .62 ,P<0 .01) .The area under ROC curve of SAA (0 .841) was larger than that of CRP (0 .749) ,and the difference was statistically significant(P<0 .05) .Conclusions:SAA could be applied as a new biomarker for AECOPD .Its serum level was correlated with the severity of disease .Early detection of SAA may be conducive to the evaluation of disease situation and the treatment strategy for disease .Thus ,it is worthy of clinical application .

Objective To use the "three-dimensional quality structure" model as a theoretical basis, based on multiple evidence-based evidence, to construct ICU nursing sensitivity quality indicators, and to provide reference for the evaluation and monitoring of ICU department nursing safety quality. Methods Evidence-based and Delphi methods were used to complete 3 rounds of inquiry among 27 experts to obtain consensus opinions of experts and to determine nursing quality indicators. Results Of the 30 articles included, 17 wereⅢA, 10 wereⅣA, 2 wereⅤA, and 1 wasⅤB. According to the"three-dimensional structure theory"model, the included indicators were sorted out and a total of 12 items were obtained. The effective recovery rate of 3 rounds of questionnaires was 96.6％, 100.0％, and 96.4％. The authoritative coefficients were 0.899, 0.895, and 0.909, and the coordination coefficients of the first, second, and third indexes were 0.340, 0.379, and 0.403, respectively,with significance (P<0.01). The final ICU nursing sensitivity quality indicator consists of 3 first-level indicators, 15 second-level indicators and 69 third-level indicators. The selection of indicators at all levels gradually converges. Conclusions The established ICU nursing sensitivity quality index accords with the principle of scientificity and practicality, and can be used for ICU department nursing quality assessment.

Objective:To explore the effect of pediatric critical illness score (PCIS), pediatric risk of mortality Ⅲ score (PRISM Ⅲ), pediatric logistic organ dysfunction 2 (PELOD-2), pediatric sequential organ failure assessment (p-SOFA) score and Glasglow coma scale (GCS) in the prognosis evaluation of septic-associated encephalopathy (SAE).Methods:The data of children with SAE admitted to the Pediatric Intensive Care Unit (PICU), Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences from January 2010 to December 2020 were retrospectively analyzed. They were divided into the survival and death groups according to the clinical outcome on the 28th day after admission. The efficiency of PCIS, PRISM Ⅲ, PELOD-2, p-SOFA and GCS scores for predicting death were evaluated by the area under the ROC curve (AUC). The Hosmer-Lemeshow goodness-of-fit test assessed the calibration of each scoring system.Results:Up to 28 d after admission, 72 of 82 children with SAE survived and 10 died, with a mortality rate of 12.20%. Compared with the survival group, the death group had significantly lower GCS [7 (3, 12) vs. 12 (8, 14)] and PCIS scores [76 (64, 82) vs. 82 (78, 88)], and significantly higher PRISM Ⅲ [14 (12, 17) vs. 7 (3, 12)], PELOD-2 [8 (5, 13) vs. 4 (2, 7)] and p-SOFA scores [11 (5, 12) vs. 6 (3, 9)] ( P<0.05). The AUCs of PCIS, PRISM Ⅲ, PELOD-2, p-SOFA and GCS scores for predicting SAE prognosis were 0.773 ( P=0.012, AUC>0.7), 0.832 ( P=0.02, AUC>0.7), 0.767 ( P=0.014, AUC>0.7), 0.688 ( P=0.084, AUC<0.7), and 0.692 ( P=0.077,AUC<0.7), respectively. Hosmer-Lemeshow goodness-of-fit test showed that PCIS ( χ2=5.329, P=0.722) predicted the mortality and the actual mortality in the best fitting effect, while PRISM Ⅲ ( χ2=12.877, P=0.177), PELOD-2 ( χ2=8.487, P=0.205), p-SOFA ( χ2=9.048, P=0.338) and GCS ( χ2=3.780, P=0.848) had poor fitting effect. Conclusions:The PCIS, PRISM Ⅲ and PELOD-2 scores have good predictive ability assessing the prognosis of children with SAE, while the PCIS score can more accurately evaluate the fitting effect of SAE prognosis prediction.

Western bioethics,with its theoretical basis in individualism,is essentially a form of universalist ethics that makes it difficult to respond to the complexities of moral life.Scholars represented by Engelhardt and MacIntyre have profoundly reflected on universalist ethics from the perspective of moral pluralism,but they have not been able to fundamentally resolve the disputes.Grasping the theoretical lineage of the controversy between universalism and particularism can provide an important reference for the construction of bioethics based on Confucianism in contemporary China.Furthermore,from the perspective of opposing universalism and particularism,as well as in response to the issues of the era of life science and technology and the cultural background of China,it can not only realize the modern interpretation of Confucian ethics,but also promote the effective application of modern bioethics theory.

This study comprehensively analyzes the course of Military Medical Psychology from 7 aspects including the nature and status, teaching objectives, teaching principles, teaching concepts, classroom teaching, practical teaching and lecturing principles, and finally summarizes the characteristics of the course and points out its shortcomings and prospects. The study found that the Military Medical Psychology is an important interdisciplinary course between medical psychology and military science; the teaching objectives include two categories, the overall goals and classified ones; the teaching principle emphasizes the forces of developing practice ability of service orientation; the teaching concept includes combining the theory with practice, focusing on the students, informatization and lectures; the mode of classroom teaching should be cases-introduction, theory-interpretation and case-analysis; the practical teaching should strengthen teaching skills, emphasize connection, stimulate interest and improve the health; lecturing principles emphasize the focus of content. This study has preliminarily completed the teaching design of the course of Military Medical Psychology, which is conducive to the smooth implementation of this course and the cultivation of professional talents of military medical universities.

OBJECTIVE To analyze the si tuation and hot spots of gabapentinoid drugs in the treatment of pain. METHODS Related researches about gabapentinoid drugs in the treatment of pain were retrieved from Web of Science core collection database during Jan. 1st，2011-Dec. 31st，2020. VOSviewer 1.6.17，CiteSpace 5.8.R1 and Excel 2018 software were used to statistically analyze the key characteristics of relevant literature ，such as the annual publications ，countries/regions，institutions，authors， journals and research hot spots. RESULTS & CONCLUSIONS A total of 3 519 literatures were retrieved ，and the annual publication outputs showed an upward trend generally. Totally 86 countries/regions had conducted relevant studies ，of which the United States ranked first （up to 1 219），and had close cooperation with the United Kingdom ，Canada，China，Germany，Japan， etc；a total of 3 996 institutions had published relevant literatures ，and the Pfizer Inc. issued the most publications ；the most studies were devoted by Professor Parsons from the University of California San Diego ，and the highest co-citations author was Professor Gilron from the Queen ’s University. Among 1 185 journals，Pain ranked first not only in the high-productive journal ，but also in the co-cited journal. The main hot topics include abuse and misuse of gabapentinoid ，off-label use of gabapentinoid ，clinical application of gabapentinoid as a component of multimodal analgesia ，and the update of guidelines for pain based on systematic evaluation and meta-analysis.