Objective Application of PDCA method to improve the coincidence rate of emergency inspection report time.Methods 472 cases of emergency inspection report returns the fraction defective of the time from September to December 2014 (blood routine,blood biochemistry,blood coagulation,cerebrospinal fluid,urine analysis).Analyzing the reason and take measures to improve the emergency inspection report time coincidence rate.At the same time,counted 654 cases of emergency inspection report returns the fraction defective of the time after the improvement from July to November 2015,and compared and analyzed the coincidence rate before and after the improvement measures.Results Emergency inspection report of the total fraction defective return time decreased from 13.9 ％ to 4.9 ％ by taking measures.Blood coagulation,blood biochemistry,urine analysis,routine blood,cerebrospinal fluid and urine analysis of emergency return time unqualified rate decreased from 18.2 ％,16.2 ％,10.3 ％,6.75 ％ and 9.1％ to 5.2 ％,5.0 ％,6.4％,5.0 ％ and 3.9 ％ respectively.Conclusion The application of PDCA could improve the time coincidence rate of emergency department,and to finish the emergency detection and report detection results in the shortest possible time.

Objective:To clarify the dynamics of Th2 related cytokines IL-4、IL-5 and the Treg T cell related cytokines TGF-β、IL-10 in children with primary steroid-sensitive nephrotic syndrome ( SSNS) from the nephrotic phase before steroid treatment to the re-mission phase.Methods:All 36 SSNS patients and 18 healthy controls matched for age , gender, body weight and height were enrolled , and their clinical characteristics were evaluated .Serum cytokine level was measured by ELISA assay .The serum levels of interleukin (IL)-4, IL-5, IL-10 and transforming growth factor (TGF)-βwere compared and correlated with serum albumin and cholesterol .Re-sults:Serum IL-4 and IL-5 levels in SSNS of nephrotic phase were higher than serum IL-4 and IL-5 levels of SSNS of remission phase and the healthy control , respectively .The serum TGF-βlevels of the nephrotic phase were significantly lower than those of remission phase or control group , whereas the serum IL-10 levels showed no significant difference between nephrotic phase and remission phase of SSNS or control group.The serum IL-4 levels had a negative correlation with serum albumin (R2 =-0.694,P=0.000), and a posi-tive correlation with serum albumin levels (R2 =0.658,P=0.000), whereas the serum TGF-βlevels had a positive correlation with serum albumin (R2 =0.838,P=0.000), and a negative correlation with serum albumin levels , had (R2 =-0.722,P=0.000). Conclusion:This study indicates that IL-4, IL-5 and TGF-βlevel is related to the pathogenesis of pediatric SSNS .

Objective To investigate the change and clinical value of serum cystain C(CysC)level in the patients with HBeAg-negative chronic hepatitis B(CHB).Methods 212 cases of CHB in our hospital were selected and divided into the HBeAg-negative group and the HBeAg-positive group according to the HBeAg status.105 healthy individuals at the same time were enrolled as the control group.The levels of serum CysC,ALT,AST,Cr,BUN and HBV DNA in 3 groups were detected and compared.The corre-lations between serum CysC with AST,AST,Cr,Bun,HBV DNA were analyzed by the Pearson correlation analysis.Results The mean CysC level in the HBeAg-negative group was (1 .40±0.36)mg/L,which was higher than (0.93±0.12)mg/L in the control group and (0.96±0.18)mg/L in the HBeAg-positive group,the differences between them was statistically significant(P <0.05). The CysC was significantly positively correlated with serum Cr level in the HBeAg-negative group(r=0.840,P <0.01).Conclusion The CysC level might be used as an effective index for monitoring the early kidney injury in the patients with HBeAg-negative CHB,which has important significance in the prevention and treatment of HBeAg-negative CHB.

Objective To investigate the relationship between rs1260326 polymorphism of glucokinase regulatory protein gene and hyperuricemia and primary gout in Enshi area populations.Methods One hundred and fifty-eight primary gout,190 hyperuricemia and 104 healthy controls (normal group) in total were collected.Hi-single nucleotide polymorphism (SNP) combined with multiplex polymerase chain reaction (PCR) with next generation sequencing techniques were used for gene polymorphism analysis,and the relationship between different alleles or genotypes and susceptibility to primary gout and hyperuricemia were analyzed.The measurement data and numeration data were statistically analyzed with t test and x2 test respectively.Logistic regression analysis was used to assess the relative risk of gout and hyperuricemia.Results The frequency of rs1260326 genotype CC,TC,TT was 8.8％(14/158),60.8％(96/158),30.4％(48/158) respectively in gout patients,15.8％ (30/190),54.7％ (104/190),29.5％ (56/190) in hyperuricemia patients,21.2％ (22/104),45.1％ (47/104),33.7％(35/104) in the normal group,the genotype distribution was significantly different in gout group and normal group (x2=9.895,P=0.007),and there was no difference between hyperuricemia group and normal group (x2=2.665,P=0.264).Allele C and T frequency was 39.2％(124/316) and 60.8％(192/316) in gout patients,43.2％(164/380) and 56.8％(216/380) in hyperuricemia patients,43.8％(91/208) and 56.2％(117/208) in the normal group.Allele T was the susceptible gene for gout.Logistic regression analysis showed that genotypes TC,TT,TC+TT increased the risk of gout.And Logistic regression analysis showed that rs1260326 single nucleotide polymorphism and hyperuricemia were no susceptibile.Conclusion Glucokinase regulatory protein (GCKR) rs1260326 sin-gle nucleotide polymorphism may be associated with primary gout risk in En Shi area,but has no significant correlation with hyperuricemia.

Objective:To describe the epidemiological and clinical characteristics of patients with novel coronavirus (2019-nCoV) -infected pneumonia in Enshi, Hubei, and to improve the awareness of the disease, which is key for surveillance and control measures of 2019-nCoV pneumonia in the region.Methods:The first 66 laboratory-confirmed 2019-nCoV patients in Enshi between January 23, 2020 and February 1, 2020 were included. Their epidemiological data, demographic data, clinical data and therapeutic effect were retrospectively analyzed.Results:Among the first 66 patients with confirmed 2019-nCoV, patients had an average age of 46±9 years, 35 (53.0%) patients were male and 31 (47.0%) female; 38 (57.6%) patients were Han, 18 (27.3%) were Tujia, and 10 (15.1%) were Miao. Thirty-seven (56%) patients had chronic diseases such as coronary heart disease, chronic bronchus, inflammation, diabetes, hypertension, hypothyroidism, and rheumatoid arthritis. All the patients had a history of exposure or indirect exposure in Wuhan epidemic area, mainly history of Wuhan sojourner. The mean incubation period varied from 2.5-16 days, with the 95th percentile of the distribution at 7 days. The main clinical manifestation were fever [66 (100%) patients], dry cough [56 (84.8%)], chest tightness [21 (31.8%)], shortness of breath [8 (12.1%)], massive fatigue [23 (34.8%)], muscle ache [6 (9.1%)], headache [4 (6.1%)], sore throat [13 (19.7%) ], rhinorrhoea [11 (16.7%) ], and diarrhea [ 5 (7.6%)]. Six (9.1%) critically ill patients and 4 (6.1%) critically ill patients had dyspnea. White blood cell counts were normal or decreased in 51 (77.3%) patients, and increased in 15 (22.7%). Lymphocyte counts were reduced or normal in 58 (87.9%) patients, and increased in 8 (12.1%) patients. Most patients had elevated CRP and erythrocyte sedimentation, and some patients had normal ranges of liver function, renal function, and electrolytes. Ten severely ill patients had elevated liver enzymes and cardiac enzymes (especially K and CKMB). There were significant differences in inflammatory markers among patients of different nationalities. Arterial blood gas analysis in 56 (84.8%) mild patients showed no significant abnormalities. Chest CT scans of 66 patients showed single or multiple small patchy shadows and interstitial changes, which were evident in the extrapulmonary band. All patients were hospitalized and isolated for treatment. Of the 66 patients received oxygen therapy, most of them received antiviral therapy (abidol/Kaletra, 0.2 g po tid/2 pills po bid) and interferon (aerosol inhalation), few patient received antibacterial therapy (Tanreqing, 20 mL ivgtt qd) and glucocorticoid therapy (methylprednisolone, 40 mg ivgtt bid), and supplemented by traditional Chinese medicine treatment. Six (9.1%) severely ill patients and 4 (6.1%) critically ill patients treated with non-invasive or invasive ventilator.Conclusions:The patients in this study are all imported cases. Most patients have mild clinical symptoms. The lungs show single or multiple small patchy shadows and interstitial changes, which are obvious with extrapulmonary bands. Seek medical treatment as soon as possible, and the above-mentioned symptomatic treatment scheme is effective. The overall morbidity and mortality in this region are lower than those in other parts of the province, and the mortality and critical illness rate of ethnic minority patients are lower than those of Han patients. There are significant differences in inflammatory markers such as leukocytes and lymphocytes among patients of different nationalities.