Objective Using ROC curve to determine the best cut-off point of serum HE-4 in the diagnosis of ovarian cancer and provide important value to diagnosis early ovarian cancer.Methods The levels of serum HE-4 in 68 ovarian cancer pa-tients,42 ovarian benign tumor patients and 30 healthy female were detected by electrochemistry irradiance method.The ROC curve was drawn and the cut-off point of HE-4 was determined by statistical software.Results The levels of serum HE-4 were all non-normal distribution in the groups of ovarian cancer,ovarian benign tumor and healthy controls.Whats more,there was no significant difference between ovarian benign tumor group and normal control group.And compared with benign ovarian tumors and normal control group,the level of HE-4 in ovarian cancers was significantly increased (P <0.01).It would be best for diagnosis when the level of serum HE-4 was 108pmol/L in ovarian cancer.Youden’s index showed the maximum (0.713)and the sensitivity and specificity of diagnosing were 77.9% and 93.1% respectively.The positive predictive value was 91.4% and negative predictive value was 91.4%.At the same time,the positive likelihood ratio was 11.6 and the negative likelihood ratio was 0.2,odds ratio reached to 47.3.Conclusion The detection of HE-4 is an ideal mark for diagnosing and excluding ovarian cancer.Selecting 108 pmol/L as ovarian cancer diagnosis point is relative appro-priate.

Objective To search the feasibility of mutation,RdxA gene was analyzed by the metronidazole induction experiment.Method The non-multiple,sensitive H.pylori strains,were selected and subjected to metronidazole induction experiment,which made H.pylori strains transform susceptibility to resistance.Extracted DNA of metronidazole sensitive and resistant pairs of H.pylori strains before and after induced,amplified by PCR and sequenced rdxA gene.Result 4 of 12 H.pylori strains were induced successfully with metronidazole whose MICs increased by 16~64 times.Strains were transferred three times on metronidazole-free medium and the MICs redetermined were the same as those after induced.There was 0.2～0.8% difference between pairs of metronidazole sensitive and resistant H.pylori strains.There was 2.2～2.7% difference between unrelated H.pylori strains.Conclusion The metronidazole induction experiment could make H.pylori acquire stable resistance to metronidazole in a short period and exclude that the natural polymorphism of rdxA gene influenced on mutation analysis.There was good hope that the experiment would become a good method to research metronidazole resistance mechanism

Objective To investigate the effects of self-efficacy-oriented nursing intervention on postoperative quality of life of lung tumor patients. Methods Ninety patients with lung tumors undergoing chest surgery in our hospital from March 2010 to March 2012 , involved in the study. The nursing data were retrospectively analyzed for investigation of the nursing strategies. The patients were randomized into two group with random digits table in equal number: The control group received routine nursing and the intervention group with self-efficacy-oriented nursing intervention beside routine nursing care. 3 months after nursing intervention , the two groups were compared by Self-rating Depression Scale (SDS) and Self-rating Anxiety Scale (SAS) in terms of quality of life and psychological state. Results The scores of the intervention group by SDS and SAS were both significantly higher than those of the control group (P < 0.05). The scores of the intervention group on self efficacy and quality of life were significantly higher than those of the control (P < 0.05). Conclusion The self-efficacy-oriented nursing intervention applied in the postoperative nursing care to lung cancer patients can significantly improve the postoperative symptoms and psychological status. It can also improve their self efficacy and then enhance their quality of life.

Objective: To create a model to predict nosocomial infections in emergency intensive care units (EICU), so as to provide insights into early identification and interventions among patients with nosocomial infections. Methods: All nosocomial infections were collected from patients hospitalized in the EICU of a large tertiary hospital from 2017 to 2020. The 2017-2019 data were selected as the training set to create a logistic regression model, and the fitting effectiveness of the predictive model was evaluated using Hosmer-Lemeshow test. The 2020 data were selected as the test set to evaluate the external validation of the predictive model. In addition, the value of the model for prediction of nosocomial infections was examined using the receiver operating characteristic (ROC) curve analysis. Results : Totally 1 546 inpatients in EICU were enrolled, and the prevalence of nosocomial infections was 7.18%. Multivariable logistic regression analysis identified hospital stay duration of >7 days (OR=21.845, 95%CI: 7.901-60.398), use of ventilators (OR=3.405, 95%CI: 1.335-8.682), and surgery (OR=1.854, 95%CI: 1.121-3.064) as risk factors of nosocomial infections. The predictive model was p=ey/(1+ey), y=-6.105+(3.084×duration of hospital stay)+(1.225×use of ventilators)+(0.617×surgery). The area under ROC curve was 0.806 (95%CI: 0.774-0.838) for the training set and 0.723 (95%CI: 0.623-0.823) for the test set, and if the 0.065 cut-off of the predictive model created by the training set was included in the test set, the predictive value yield a 0.739 sensitivity and 0.642 specificity for prediction of nosocomial infections among patients hospitalized in EICU. Conclusion The created predictive model for nosocomial infections among patients hospitalized in EICU presents a high accuracy, which shows a satisfactory predictive value for high-risk nosocomial infections.

OBJECTIVE:To establish a method for the simultaneous determination of loganic acid and isoscoparin in Sanwei longdanhua tablets. METHODS:HPLC method was adopted. The determination was performed on Inertsil ODS-3 column with mobile phase consisted of methanol-0.2% phosphoric acid (gradient elution) at the flow rate of 1.0 mL/min. The detection wavelength was set at 240 nm,and column temperature was 30 ℃. The sample size was 10 μL. RESULTS:The linear range were 0.040 08-4.008 0 μg(r＝0.999 9)for loganic acid and 0.021 96-2.196 0 μg(r＝0.999 9)for isoscoparin. The quantitative limits were 0.160 32 and 0.087 8 ng/mL,and detection limits were 0.080 16 and 0.043 92 ng/mL. RSDs of precision,stability and reproducibility tests were all lower than 2%. The recoveries were 103.07%-104.26%(RSD＝0.52%,n＝6) and 95.57%-99.61%(RSD＝1.55%,n＝6). CONCLUSIONS:The method is simple,accurate and suitable for simultaneous determination of loganic acid and isoscoparin in Sanwei longdanhua tablets.

As an ideal surgical method for treating corneal endothelial decompensation, endothelial keratoplasty has been widely applied.It has many advantages, but there are also complications during graft preparation, intraoperative operation and postoperative recovery.The two common types of corneal endothelial keratoplasty, Descemet-stripping automated endothelial keratoplasty and Descemet membrane endothelial keratoplasty, were taken as examples in this article to introduce the treatment of complications during graft preparation, such as graft perforation and graft tear, intraoperative complications, for instance, difficulty in expanding graft and graft inversion, postoperative complications including graft detachment, high intraocular pressure, etc.The incidence of complications at different stages of endothelial keratoplasty, influencing factors and treatment methods were reviewed to provide a reference for clinicians to diagnose and treat complications of endothelial keratoplasty at various stages.

Objective:To explore the efficacy of quantitative parameters of dual-layer spectral CT in preoperative prediction of Ki-67 expression in esophageal squamous cell carcinoma (ESCC).Methods:From December 2021 to December 2022, 64 patients with histopathologically diagnosed ESCC were retrospectively analyzed at Liaoning Cancer Hospital & Institute. The expression level of Ki-67 in ESCC tumor tissue was detected by the immunohistochemical method. The patients were divided into the Ki-67 high expression group (the Ki-67 expression index≥30%, 47 cases) and the Ki-67 low expression group (the Ki-67 expression index<30%, 17 cases). The quantitative parameters of spectral CT were measured, including traditional 120 kVp CT value, 40 keV CT value, iodine density (ID), normalized iodine density (NID), and Z-effective in arterial and venous phases. Independent sample t test was used to compare the differences in the parameters between the Ki-67 high and low expression groups. The receiver operating characteristic (ROC) curve was drawn to evaluate the efficacy of each parameter in predicting Ki-67 expression. DeLong test was used to compare the area under the curve (AUC). Results:The 120 kVp CT value, 40 keV CT value, ID, and Z-effective in the arterial phase and the 120 kVp CT value, 40 keV CT value, ID, NID, Z-effective in venous phase in the Ki-67 high expression group were all higher than those in the Ki-67 low expression group ( P<0.05). There was no statistically significant difference in arterial phase NID between the two groups ( t=1.85, P=0.070). NID in the venous phase had the highest AUC in predicting high expression of Ki-67 in ESCC (AUC=0.965, 95%CI 0.923-1.000). With a venous phase NID value of 0.28 as the diagnostic threshold, the sensitivity and specificity were 93.6% and 100%. There was no significant difference in AUC between venous phase NID and venous phase ID (AUC=0.926) and Z-effective (AUC=0.909) ( Z=-1.52, 1.81, P=0.128, 0.071), but there was a significant difference of AUC between venous phase NID and 120 kVp CT value (AUC=0.719) and 40 keV CT value (AUC=0.747) ( Z=3.41, 3.30, P=0.001, 0.001). There were statistical differences of AUC between venous phase NID and each parameter of arterial phase ( P<0.05). Conclusion:The three spectral CT parameters (ID, NID, and Z-effective) in the venous phase have high diagnostic efficacy in predicting ESCC Ki-67 expression.

Objective To evaluate the accuracy of different noninvasive methods for the diagnosis of nonalcoholic steatohepatitis(NASH) and hepatic fibrosis in patients with non-alcoholic fatty liver disease (NAFLD) combined with type 2 diabetes mellitus(T2DM). Method A prospective comparative study was performed for 91 patients with T2DM and NAFLD, which were diagnosed by glucose tolerance test and liver biopsy. The height and body mass of the patient were measured, and the body mass index(BMI) was calculated. The fasting venous blood of the patient was collected, and then the blood routine, liver function and ferritin were measured. NPS, neutrophil lymphocyte ratio(NLR), BARD score, FIB-4 index, APRI, and NAFLD fibrosis score(NFS) were calculated. All patients underwent transient elastography (Fibrotouch) to evaluate the degree of liver stiffness measurement (LSM) and controlled attenuation parameter. All the liver biopsy specimens were categorized by SAF as the gold standard for evaluating NASH and liver fibrosis NASH. Correlation analysis was applied to compare the correlation between the noninvasive methods and SAF. The receiver operating characteristic (ROC) curve and the area under the curve (AUC) were used to assess the diagnostic value of the noninvasive methods for NASH and liver fibrosis NASH. Results In T2DM combine with NAFLD patients, NPS, LSM, NFS, APRI, FIB4 and BMI scores were positively correlated with SAF (r value was 0.509, 0.508, 0.252, 0.396, 0.313 and 0.213, respectively; P value was <0.001, <0.001, 0.016,<0.001, 0.003 and 0.043, respectively). LSM, NPS, NFS and FIB4 scores were positively correlated with liver fibrosis (r value was 0.535, 0.337, 0.315 and 0.315, respectively; P value was <0.001, 0.001, 0.002, 0.002, respectively). The ROC curve shows that the area under the curve of NPS, LSM, APRI, FIB4 and BMI for diagnosing NASH was 0.838, 0.760, 0.734, 0.623 and 0.682, respectively, and P value was 0.000, 0.000, 0.000, 0.044 and 0.003, respectively. For the diagnosis of fibrotic NASH, that value of LSM, NFS, FIB4 and NPS was 0.795, 0.765, 0.686 and 0.623, respectively, and P value was 0.000, 0.001, 0.020 and 0.123, respectively. Conclusions NPS, LSM and APRI have good clinical diagnostic value for NASH. LSM and NFS have good diagnostic value for fibrotic NASH.

OBJECTIVE To study the content changes of ch emical constituents of processed products of Terminalia chebula at different temperatures ，and to compare its anti-ulcerative colitis effect. METHODS Processed products of T. chebula at different temperatures（160，180，200，220，240，260，280，300 ℃）were prepared by sand scalding technology. HPLC method was adopted to determine the contents of gallic acid ，chebulagic acid ，chebulinic acid and ellagic acid in crude drug and processed products of T. chebula at different temperatures. The mice were divided into blank group ，model group ，Mesalazin enteric-coated tablets group （positive control ，0.4 g/kg），crude drug and processed products groups of T. chebula at different temperatures （1.3 g/kg），with 10 mice in each group. Except for blank group ，other groups were given 6％ acetic acid 0.1 mL via anus to induce ulcerative colitis model. After modeling ，blank group and model group were given water intragastrically ，and other groups were given relevant drug intragastrically ，20 mL/kg，once a day ，for consecutive 7 days. The general physical signs of mice in each group were observed and the body weight was recorded. The colorectal length and index ，serum levels of related inflammation indexes [superoxide dismutase （SOD），malondialdehyde （MDA），interleukin-10 （IL-10），IL-1 β ，tumor necrosis factor α （TNF-α）] were detected. The pathomorphological changes of colon and rectum were observed ，and the comprehensive score of pharmacodynamics was performed. RESULTS With the increase of processing temperature ，the contents of chebulagic acid and chebulinic acid decreased gradually ，the content of gallic acid increased first and then decreased ，and the content of ellagic acid increased. Compared with model group ，the general physical signs ，body weight ，colorectal length ，colorectal index and related inflammation indexes were all improved significantly in crude drug and processed products groups of T. chebula at different temperatures（P＜0.05 or P＜0.01）. The glandular recess structure of colorectal tissue was repaired ，the infiltration of inflammatory cells was reduced ，and the comprehensive score of efficacy of processed products prepared at 260 ℃ was the highest. CONCLUSIONS The contents of chemical components in T. chebula processed at different temperatures change significantly and their anti-ulcerative colitis effects are different. The processed products of T. chebula prepared at 260 ℃ show the best anti-ulcerative colitis effect.

Objective: To describe the distribution and drug resistance of pathogens at hematology department of Jiangsu Province from 2014 to 2015 to provide reference for empirical anti-infection treatment. Methods: Pathogens were from hematology department of 26 tertiary hospitals in Jiangsu Province from 2014 to 2015. Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or agar dilution method. Collection of drug susceptibility results and corresponding patient data were analyzed. Results: The separated pathogens amounted to 4 306. Gram-negative bacteria accounted for 64.26%, while the proportions of gram-positive bacteria and funguses were 26.99% and 8.75% respectively. Common gram-negative bacteria were Escherichia coli (20.48%) , Klebsiella pneumonia (15.40%) , Pseudomonas aeruginosa (8.50%) , Acinetobacter baumannii (5.04%) and Stenotropho-monas maltophilia (3.41%) respectively. CRE amounted to 123 (6.68%) . Common gram-positive bacteria were Staphylococcus aureus (4.92%) , Staphylococcus hominis (4.88%) and Staphylococcus epidermidis (4.71%) respectively. Candida albicans were the main fungus which accounted for 5.43%. The rates of Escherichia coli and Klebsiella pneumonia resistant to carbapenems were 3.5%-6.1% and 5.0%-6.3% respectively. The rates of Pseudomonas aeruginosa resistant to tobramycin and amikacin were 3.2% and 3.3% respectively. The resistant rates of Acinetobacter baumannii towards tobramycin and cefoperazone/sulbactam were both 19.2%. The rates of Stenotrophomonas maltophilia resistant to minocycline and sulfamethoxazole were 3.5% and 9.3% respectively. The rates of Staphylococcus aureus, Enterococcus faecium and Enterococcus faecalis resistant wards vancomycin were 0, 6.4% and 1.4% respectively; also, the rates of them resistant to linezolid were 1.2%, 0 and 1.6% respectively; in addition, the rates of them resistant to teicoplanin were 2.8%, 14.3% and 8.0% respectively. Furthermore, MRSA accounted for 39.15% (83/212) . Conclusions Pathogens were mainly gram-negative bacteria. CRE accounted for 6.68%. The rates of Escherichia coli and Klebsiella pneumonia resistant to carbapenems were lower compared with other antibacterial agents. The rates of gram-positive bacteria resistant to vancomycin, linezolid and teicoplanin were still low. MRSA accounted for 39.15%.