Objective To explore the risk factors of surgical site infection(SSI)in patients undergoing selective brain tumor resection,and provide reference for clinical prevention and treatment.Methods Patients who under-went selective brain tumor resection in the neurosurgery department of a hospital during April-September 2013 and April-September 2014 were monitored prospectively,monitoring programme and individualized questionnaire were formulated,the basic data,operation condition,postoperative symptoms/signs,laboratory test results,infection-related factors,and antimicrobial use in patients were collected,risk factors for infection were analyzed.Results A total of 205 patients were investigated,23 (11 .22%)of whom had SSI;univariate analysis showed that body mass index (BMI),NNIS score,and cerebrospinal fluid leakage were related to the occurrence of SSI(all P<0.05);lo-gistic regression analysis showed that high NNIS score and cerebrospinal fluid leakage were independent risk factors for SSI in patients undergoing selective brain tumor resection(both P<0.05).Conclusion Incidence of SSI is high-er in patients with selective brain tumor resection,corresponding preventive measures should be taken according to different risk factors including cerebrospinal fluid leakage.

Objective To assess the outcome of fixation of Rüedi-Allg(o)wer type Ⅱ and Ⅲ pilon fracture using multiple low-profile plates (MLPP) via multiple incisions.Methods A retrospective study was made on 21 cases of pilon fracture immobilized using MLPP via multiple incisions between July 2007 and March 2012.There were 7 cases of Rüedi-Allgower type Ⅱ and 14 type Ⅲ.Fractures were reduced and fixed based on X-ray films and CT scans for fracture line and effect area.Quality of reduction was evaluated by Burwell-Charnley radiological score.Ankle and hindfoot functions were evaluated by American Orthopedic Foot & Ankle Society ankle-hindfoot scale.Fracture types,healing rate,and wound complication incidence were recorded.Results All fractures were healed,with the excellence rate of 95％ (20/21).According to AOFAS score,the results were rated as excellent in 11 cases,good in 6,fair in 4,with the excellence rate of 81％.None suffered from wound infection,except for wound dehiscence in 1 case and traumatic arthritis in 5.Conclusion Treatment of pilon fractures by MLPP via multiple incisions can reduce wound complications,promote reduction and stabilization of fracture,and satisfy the demand of early movement and late weight bearing of the ankle.

Objective To investigate the relationship between the expression of ITGAV and the radiosensitivity of NSCLC cells. Methods The expression of ITGAV in NSCLC and its relationship to the prognosis of patients who received radiotherapy were analyzed using bioinformatics methods. Differences in radiosensitivity between radio-resistant cells and parent cells were verified by clone formation experiment, and the protein expression of ITGAV was detected by Western blot. The transfection efficiency of si-ITGAV was determined by Western blot and qRT-PCR analyses. The best ITGAV interference sequence was selected to transfect A549R and H1299R cells. Clone formation experiment and flow cytometry were used to detect clone formation, apoptosis and cell cycle of A549R and H1299R cells. Results The expression of ITGAV in NSCLC tissues was significantly higher than that in normal tissues (P<0.05), and NSCLC patients with high ITGAV expression had poor prognosis. The clonogenic ability of the si-ITGAV group was significantly lower than that of the negative control group at 4, 6, 8Gy irradiation (all P<0.05). After 6 Gy irradiation, the apoptosis of the si-ITGAV group was increased (P_H1299R<0.0001, P_A549R=0.0002), the proportion of G₂/M phase cells to A549-siITGAV and H1299R-siITGAV cells was higher than that in the negative control group (P_H1299R<0.0001, P_A549R=0.0007). Conclusion Interfering with ITGAV expression can increase the radiosensitivity of NSCLC.

Objective To explore the influence of field tracing defect situational simulation teaching on new nurses' critical thinking. Methods From 2015 to 2016, the new nurses from a general Class Ⅲ hospital were selected by cluster sampling method. The 2015 new nurses were assigned as control group (n=75), and the 2016 new nurses were assigned as observation group (n=83). Traditional situational simulation teaching was adopted in the control group, while the field tracing defect situational simulation teaching was applied in the observation group. The effects of training was evaluated with Chinese Version of Critical Thingking Disposition Inventory. Results The results of critical thinking ability of both the groups increased after training (P<0.05). The result of the observation group was (265.87±44.19), which was higher than that of the control group (243.39±37.25), and the difference was statistical significant (t=3.438, P=0.001). Conclusions The field tracing defect situational simulation teaching can effectively improve new nurses' critical thinking ability.

Objective:To investigate the diagnostic and prognostic value of the growth differentiation factor 15 (GDF15) and the procalcitonin (PCT) in sepsis.Methods:A total number of 137 patients with sepsis (considered as the sepsis group) and 59 patients with inflammatory infection but not diagnosed as sepsis (the non-sepsis group) received treatment in intensive care unit of Renming Hospital of Wuhan University were collected from July 2020 to January 2021, and 62 cases of healthy physical examination (control group) were simultaneously chosen as control. Sepsis patients were divided into two groups (death group [ n=48] and survival group [ n=89]) according to their 28-day′s survival. The serum levels of GDF15, PCT, C-reactive protein (CRP), interleukin-6 (IL-6) and interleukin-10 (IL-10) were examined, and the levels of each index, was dynamically monitored on the 1st, 3rd and 7th day after admission. The differences of the two indicators between different groups were compared by non-parametric test. The correlation between GDF15 and PCT was analyzed by Spearman correlation test. The receiver operating characteristic (ROC) curve was drawn to evaluate the diagnostic and prognostic value of the two indicators for sepsis. Results:The levels of GDF15 in the sepsis group, non-sepsis group and control group were 3.22 (1.39, 6.31) μg/L, 0.84 (0.21, 1.66) μg/L and 0.11 (0.09, 0.13) μg/L, respectively. The levels of PCT were 13.10 (1.99, 50.25) μg/L, 0.24 (0.13, 0.68) μg/L and 0.05 (0.03, 0.10) μg/L, respectively. The levels of CRP were 115.80 (26.40, 184.07) mg/L, 24.20 (11.30, 53.20) mg/L and 0.50 (0.50, 2.76) mg/L, respectively. The levels of IL-6 were 68.26 (21.59, 255.46) ng/L, 33.20 (10.81, 89.27) ng/L and 8.82 (7.33, 11.23) ng/L, respectively. The levels of IL-10 were 11.30 (5.88, 25.50) ng/L, 9.34 (5.65, 16.90) ng/L and 4.94 (4.31, 5.31) ng/L, respectively. The GDF15, PCT, CRP and IL-6 of the sepsis group were significantly higher than those of the non-sepsis group (The U values were 67.681, 86.034, 44.164 and 38.934, respectively, with P values less than 0.05) and the control group (The U values were 136.475, 138.667, 120.701 and 100.886, respectively, with P values less than 0.001). There was no significant difference in IL-10 between sepsis group and nonsepsis group, but it was higher than that of control group ( U=80.221, P<0.001). There was a positive correlation between GDF15 and PCT in patients with sepsis, and the spearman correlation coefficient was 0.234 ( P=0.006). The GDF15 of the death group and the survival group were 5.49 (3.60, 8.25) μg/L and 2.03 (1.06, 3.69) μg/L, and the PCT levels were 26.45 (11.23, 94.25) μg/L and 9.08 (1.33, 22.75) μg/L, respectively. GDF15 and PCT in the death group were significantly higher than those in the survival group ( U values were 3 305.500 and 3 060.000, respectively, and P values were both less than 0.001). The GDF15 and PCT levels in the death group were higher than those in the survival group on the 1st, 3rd and 7th day of dynamic monitoring ( P<0.05), however, the level of CRP and IL-10 were not significantly different ( P>0.05). The level of IL-6 in the death group was not significantly different from that of the death group on 1st day, but was higher than that of the survival group on the 3rd and 7th day ( P<0.05). The area under the curve (AUC) of GDF15, PCT, CRP, IL-6 and IL-10 alone and in the combined diagnosis of sepsis were 0.899, 0.938, 0.874, 0.789, 0.698 and 0.962, respectively. The combined detection of AUC was better than a single index; the GDF15, PCT, CRP, IL-6 and IL-10 alone and combined detection of sepsis prognosis AUC were 0.774, 0.716, 0.522, 0.623, 0.520 and 0.839, respectively, the combined detection of AUC is also better than single index. Conclusions:GDF15 and PCT have good clinical reference value in the differential diagnosis and prognosis of sepsis. The combination of indicators has a higher clinical value. GDF15 may become a biomarker for the diagnosis and prognosis of sepsis.

Objective To explore the influence of organizational safety atmosphere on work enthusiasm among junior nurses in ICU,so as to provide reference for improving job engagement and work quality of junior nurses in ICU. Methods In December 2016,213 junior nurses in ICU from 12 comprehensive class Ⅲhospitals in Nanning,Guilin and Liuzhou in Guangxi were selected and surveyed by the Safety Organizing Scale(Chinese version)and Questionnaire on Work Enthusiasm Appraisal. Influence of organizational safety atmosphere perceived by junior nurses in ICU on their work enthusiasm was analyzed. Results For the junior nurses in ICU,scores of safety organizing were(38.60±7.12)points,and scores of work enthusiasm were (57.04±8.23);differences of junior nurses' work enthusiasm scores under different organizational safety atmosphere were statistically significant(F=10.908,P< 0.001). Work enthusiasm and its dimensions were positively related to organizational safety atmosphere(P<0.05). Conclusions The more safety organizing investment is,the higher work enthusiasm is of junior nurses in ICU.

Objective? To analyze the bias of dimension measurement results of penis and testis by the self-design cylinder boy penis and testicles measurement (hereinafter called cylinder ruler) and it influencing factors. Methods? From June to December 2018, we selected 152 children of Department of Urinary Surgery in Hu'nan Children's Hospital as subjects by case sampling. Children's penis and testicles dimension were measured repeatedly by their patients and nurses with the self-designed cylinder ruler and three kinds of common clinical measurement tools (vernier caliper+tape measure+testis measurer, vernier caliper+straightedge, vernier caliper+round head probe), and the bias were counted based on medical reference value. Results? Measurement bias of length and diameter of penis in a resting state, length of penis in a traction state, length and width of testis in group of cylinder ruler were lower than those in other groups with statistical differences (P＜0.05) which not influenced by boys' ages and measurement time (P＞ 0.05). Bias of length of penis in a traction state, length and width of testis measured by nurses were lower than those by children's patients with statistical differences (P＜ 0.05). Interaction effect analysis showed that there were no statistical differences in dimension of penis and testis measured by different measurers with the cylinder ruler (P＞0.05); however, there were statistical differences in dimension of penis and testis measured with the cylinder ruler by different measurers at different times of a day (P＜0.05). The differences of interaction effects between measurement time and measurers were statistical (P＜0.05). Conclusions? Compared with other measurements, the self-designed cylinder ruler for measurement of penis and testis in boys has higher accuracy. The main influencing factors of bias of dimension of boys' penis and testis are ages of boys and measurement time. Bias of length of penis in a traction state, length and width of testis measured by nurses are lower than those by children's patients. Measurers and measurement time are not suggested as independent factors when analyzing the influencing factors of dimensions measurement bias of penis and testis. Dimensions of penis and testis are measured with the cylinder ruler at different times which have certain changes.