Objective: To investigate the value of fibrinogen to albumin ratio (FAR) at admission on predicting spontaneous recanalization of infarct-related artery (IRA) in patients with acute ST-segment elevation myocardial infarction (STEMI). Methods: Clinical data from 255 acute STEMI patients ((61.1±11.2) years old, 189 males) who underwent emergency coronary angiography within 12 hours in our hospital from December 2015 to April 2018 were retrospectively analyzed. The acute STEMI patients were divided into non-spontaneous recanalization group (thrombolysis in myocardial infarction (TIMI) flow grade 0-1, 203 cases) and spontaneous recanalization group (TIMI flow grade 2-3, 52 cases). Multivariate logistic regression analysis was used to evaluate related factors of IRA spontaneous recanalization. The receiver operating characteristic (ROC) curve was used to evaluate the value of FAR in predicting spontaneous coronary recanalization. Results: There was no significant difference in age,gender, hypertension, diabetes, smoking,systolic blood pressure,diastolic blood pressure,heart rate, duration of chest pain, type of infarction, infarct-related artery, door-to-balloon time, and drug used before admission between non-spontaneous recanalization group and spontaneous recanalization group (all P>0.05). The FAR and high-sensitivity C-reactive protein levels were significantly lower in the spontaneous recanalization group than in the non-spontaneous recanalization group (8.20±1.85 vs. 11.02±2.75, P<0.001; (6.87±3.36) g/L vs. (8.51±3.72) g/L, P=0.004). Multivariate logistic regression analysis showed that FAR (OR=0.492, 95%CI 0.354-0.686, P<0.001), serum uric acid (OR=0.994, 95%CI 0.989-0.999, P=0.018) and high-sensitivity C-reactive protein (OR=0.774, 95%CI 0.614-0.975, P=0.030) were independent negative correlation with spontaneous recanalization of infarct-related artery in patients with acute STEMI. The ROC curve showed that the area under the curve of FAR predicting spontaneous recanalization of infarct-related artery in patients with acute STEMI was 0.807 (95%CI 0.630-0.758, P<0.001), and the diagnostic threshold was 9.26, the sensitivity was 76.9%, the specificity was 75.9%. Conclusion The level of admission FAR has certain predictive value for spontaneous recanalization of infarct-related arteries in patients with acute STEMI.

【Objective:】 To explore the relationship between the moral courage of nurses in Intensive Care Unit (ICU) and the hospital ethical climate, and to provide a theoretical basis for enhancing the moral courage of ICU nurses. 【Methods:】 A total of 468 ICU nurses from 8 tertiary A hospitals in Shaanxi Province were selected as the subjects by convenience sampling method, and the General Information Form, Hospital Ethical Climate Survey, and Nurses’ Moral Courage Scale were used for the questionnaire survey. 【Results:】 A total of 468 questionnaires were distributed and 463 valid questionnaires were returned, with an effective recovery rate of 98.93%. The score of hospital ethical climate for ICU nurses was (100.69±19.76), and the score of moral courage was (83.67±15.48). There was a positive correlation between hospital ethical climate and moral courage (r=0.866, P<0.001). Hierarchical multiple regression analysis showed that hospital ethical climate entered the influencing factor model of ICU nurses’ moral courage, which can independently explain 57% of the variation in ICU nurses’ moral courage. 【Conclusion:】 The moral courage of ICU nurses was at a medium level, and positively correlated with the hospital ethical climate, that is, the better the hospital ethical climate perceived by ICU nurses, the higher their level of moral courage. Nursing managers should focus on deepening the hospital ethical climate, and enhance the level of hospital ethical climate through scientific methods to promote the improvement of ICU nurses’ moral courage.