Objective To construct a delirium risk prediction model for patients in the intensive care unit(ICU)based on the related psychological risk factors of delirium,and provide a new idea for the identification of delirium in ICU patients.Methods A prospective observational study method was conducted.From September 2019 to September 2020,a total of 165 patients in the department of ICU of the Second Affiliated Hospital of Chongqing Medical University were selected as the research objects.The patients were assessed by general information questionnaire,eysenck personality questionnaire-revised,short scale for Chinese(EPQ-RSC),state-trait anxiety inventory(STAI),Hamilton depression scale(HAMD),trait coping style questionnaire(TCSQ),and confusion assessment method of ICU(CAM-ICU).The binary Logistic regression model was used to explore the risk factors of delirium in ICU patients,and a nomogram model was constructed to verify the accuracy of the model.Results After excluding 7 cases of invalid data,158 patients were finally included,23 were believed to be suffering from delirium,and the incidence of delirium was 14.56%.The univariate analysis showed that compared with the non-delirium group,the age of patients was significantly increased(years:72.91±6.75 vs.63.36±10.14),the proportion of patients with history of alcoholism,cognitive impairment and mechanical ventilation in the delirium group was significantly increased[history of alcoholism:17.4%(4/23)vs.5.2%(7/135),history of cognitive impairment:30.4%(7/23)vs.5.2%(7/135),history of mechanical ventilation:78.3%(18/23)vs.40.7%(55/135),all P<0.05],the length of ICU stay was significantly prolonged(days:7.26±1.66 vs.4.93±2.15),the neuroticism score(7.78±2.66 vs.5.07±2.77),the negative coping score(30.70±6.54 vs.25.76±5.41),the HAMD depression score(15.04±4.55 vs.10.76±3.77),and the trait anxiety score(49.48±7.14 vs.44.10±8.66)were significantly increased(all P<0.05).Logistic regression analysis showed that age,neuroticism score,HAMD depression score,trait anxiety score,the length of ICU stay,and history of mechanical ventilation were all risk factors for delirium in ICU patients[odds ratio(OR)value and 95%confidence interval(95%CI)were 1.11(1.02-1.22),1.50(1.13-1.99),1.39(1.15-1.69),1.13(1.03-1.25),1.47(1.04-2.06),6.52(1.19-35.73),P values were 0.02,0.01,0.01,0.01,0.03,0.03,respectively].A nomogram model was constructed based on the delirium risk factors,area under the curve(AUC)=0.96 and 95%CI was 0.93-0.99,the Youden index was 0.87,the sensitivity was 100%,and the specificity was 87%.The results of the Hosmer-Lemeshow goodness of fit test suggested thatχ2=5.13,P=0.74,suggesting that the prediction model had good discrimination.Conclusion This study constructed a risk prediction model for delirium in ICU patients based on neuroticism,depression,trait anxiety and other factors,and the result showed that the model had good discrimination and accuracy,offering a new method for identifying ICU patients at high risk of delirium.

Female ; Humans ; Hypoglycemic Agents/therapeutic use* ; Insulin Resistance ; Metformin/therapeutic use* ; Phosphatidate Phosphatase ; Pioglitazone/therapeutic use* ; Polycystic Ovary Syndrome/genetics*

Objective:To explore the spatio-temporal patterns and epidemic characteristics of imported dengue fever cases in six provinces (Yunnan, Guangxi, Guangdong, Hainan, Fujian and Zhejiang) of China from 2016 to 2018.Methods:In this study, we collected the surveillance data of imported dengue fever cases from 2016 to 2018 in six southern provinces of China. The risk intensity, spatio-temporal distribution and epidemiological characteristics of imported dengue fever cases in the six provinces were analyzed from the perspective of space, time and population.Results:Among the imported cases of dengue fever in China from other countries in the world, most of them were from Southeast Asia. In Zhejiang, Fujian and Guangdong provinces, there were greater number of imported cases with wide range of sources. While in Yunnan, Guangxi and Hainan provinces, the imported cases were almost from Southeast Asia. The incidence of imported dengue fever increased during the past three years, and the annual incidence peak was during August-November, but slight differences were observed among provinces. The age of the imported cases in Hainan[(37.0±19.6) years] was higher than that in southeastern coastal provinces[(36.0±11.7) years] and in southwestern provinces[(32.0±16.3) years]. The male-female ratio of the cases in southeastern coastal provinces (2.18∶1) were higher than those in southwestern provinces (1.04∶1) and Hainan (1.38∶1). The occupations of the cases were mainly workers and unemployed people in southeastern coastal provinces and farmers in southwestern provinces, but commercial personnel was the population with high incidence in both southeastern and southwestern provinces. Less imported dengue fever cases were reported in Hainan, the population distribution varied.Conclusions:There were differences in incidence pattern of imported dengue fever between southeastern coastal provinces and southwestern provinces as well as Hainan in China. Different prevention and control measures should be carried out in different areas to implement more precise prevention strategies.

Objective: To explore the effect of ISBAR communication mode on the bed shift in severe patients. Methods: The "ISBAR Nursing Delivery Card near the Bed of Severe Diseases Medicine" was formulated. 100 cases of severe patients admitted from February 2018 to March 2018 were set up as control group by experimental research methods. 100 cases of severe patients admitted from April 2018 to May 2018 were set up as experimental group and non-random control was established. The patients in the experimental group were treated with ISBAR nursing shift card for bed shift, and the control group were treated with normal oral shift. Observe and compare the incidence of nurse shift problems, the score of nurse shift assessment scale and the nurse′s knowledge of the patient′s condition "ten know" score between the two groups. Results: The incidence of nurse shift problems dropped from 39.50% (79/200) of control group to 16.50% (33/200) of experimental group, which had a significant difference (χ²=42.938, P<0.01). The score of the nurse′s succession assessment table was increased from (57.80 ± 3.61) points of control group to (73.96 ± 2.33) points of experimental group, which had a significant difference (t=-26.10, P<0.05). The nurse′s knowledge of the patient′s condition "ten know" had been increased from (72.14±4.13) points of control group to (87.75±2.54) points of experimental group, which had a significant difference (t=-32.01, P<0.05). Conclusion The use of ISBAR communication mode for serious patients in the severe medical department can effectively reduce the incidence of nurse shift problems, effectively improve nurses 'satisfaction with shift and the degree of mastery of patients′ conditions, and the effect of shift is better.

Objective To explore the better humidification oxygen therapy for patients with artificial airway from weaning to extubation, ensure the best humidification effect, keep airway unobstructed,shorten tubulization time and reduce the incidence of infection. Methods A total of 133 patients with artificial airway during weaning from ventilation admitted from March to December in 2016 in intensive care unit of the Second Affiliated Hospital of Chongqing Medical University were included in the study.They were divided into the experimental group(69 patients)and the control group(64 patients) by random lottery form.The experimental group was given improved combination device(venturi,heated humidifier and ventilator tube)during oxygen therapy for humidification and heating, while the control group was treated with oxygen therapy in endotracheal tube and continuous wet micro-injection pump 0.45% sodium chloride method.The heart rate,respiratory rate,blood oxygen saturation,offline time with tube,offline failure rate,sputum viscosity,sputum scab formation,irritant cough and pulmonary infection were compared between the two groups. Results The heart rate,respiratory rate,blood oxygen saturation and offline time with tube in the experimental group were(80.50±7.07)times/min,(17.38±1.92)times/min, 0.98±0.01,and(1.58±1.06)days,and which were(88.50±3.07)times/min,(21.38±1.51)times/min,0.96± 0.01 and(3.00±1.09)days in the control group.The differences were statistically significant(t=2.268-4.782,P<0.05 or 0.01).The offline failure(2 cases),sputum scab formation(3 cases),irritant cough(4 cases) and pulmonary infection(4 cases) were less than 8 cases, 12 cases, 20 cases,12 cases in control group. The differences were statistically significant (χ2=4.652-14.545, P < 0.05 or 0.01). The sputum viscosity ofⅠ,ⅡandⅢwere 5 cases,52 cases and 12 cases in the experimental group,which were better than 13 cases,11 cases and 40 cases in the control group.The difference was statistically significant(Z=3.385, P < 0.01). Conclusions The improved oxygen therapy heated humidify strategy can not only achieve satisfactory humidification effect, but also improve the success rate of offline machines, shorten tubulization time,promote the comfort and tolerance of patients,and reduce the occurrence of infection.

Objective To discuss the tympanic membrane puncture or tympanostomy tube under endotoscope combined with adenoidectomy under nasal endoscopy on the influence of invalid conservative treatment of pediatric secretory otitis media.Methods A total of 112 cases of secretory otitis media with invalid conservative treatment were selected in the department of otorhinolaryngology of children′s hospital of Nanjing Medical University from July 2013 to August 2015.They were divided into three groups,the group A of 38 cases(68 ears)underwent transnasal endoscopic pure adenoidectomy;the group B of 37 cases(60 ears)underwent transnasal endoscopic adenoidectomy combined with tympanocentesis;the group C of 37 cases(59 ears)underwent tympanostomy tube insertion.The clinical treatment effect,the period of middle ear effusion,postoperative recurrence and complication were observed and compared.Results The total effective rate of the 3 groups was improved after 3 months(P<0.05);the total effective rate in group B and group C at one week and 3 months after operation were higher than those of group A(P<0.05);and the total effective rate in group C at 3 months after operation was significantly higher than that of group B(P<0.05).The level of auditory brainstem evoked potential(ABR)and the latency of ABR wave Ⅰ latency were decreased at 1 year after operation(P<0.05);the ABR changes in group B and group C at 1 week and 1 year after operation were lower than those in group A(P<0.05).The incidence of recurrence rate and the period of middle ear effusion in group C were lower than those in group A and B(P<0.05).The incidence of complication of group A was lower than those of group B and group C(P<0.05).Conclusion Using tympanostomy tube combined with adenoidectomy under endoscope can improve the children with hearing,which not only can shorten the time of the middle ear effusion,but also effectively reduce the recurrence rate.

Objective To detect the expression of hypoxia-inducible factor 1α (HIF-1α) and bcl-2 ovarian serous carcinoma and their clinical significances. Methods Paraffin specimens including 61 cases of ovarian serous carcinoma and 50 normal ovarian tissues were selected. The expressions of HIF-1α and bcl-2 proteins were detected by immunohistochemical EnVision method and their relationship between them was analyzed. Results The positive rate of HIF-1α and bcl-2 proteins expression in 61 ovarian serous carcinoma was 68.9%and 54.1%, respectively. There was a significant difference between the two groups (χ2=55.381, P< 0.05; χ2= 38.493, P< 0.05). The clinical pathological parameters showed that the positive expression of HIF-1αand bcl-2 proteins were not related with the age (P>0.05). HIF-1αpositive expression was correlated with tumor grades, the state of lymph node metastasis and FIGO stages (χ2=4.931, 25.008, 5.610, P<0.05). Bcl-2 was significantly associated with tumor grades and lymph node metastasis (χ2= 6.956, 33.869, P<0.05), but not with FIGO stages (χ2=3.391, P>0.05). The expression of bcl-2 was positively correlated with HIF-1α in ovarian serous carcinoma (r= 0.304, P= 0.017). Conclusions The expressions of HIF-1α and bcl-2 play a synergic role in the progression of ovarian serous carcinoma. The combined detection of HIF-1αand bcl-2 is effective for patients'prognosis judgment.

Objective To develop and establish the role adaptation scale (RAS) in new nurses. Methods We analyzed and evaluated the cultural differences,validity and reliability of RAS by interviewing 5 nursing experts and investigating 307 new nurses.Results There were good face validity,content validity and construct validity (0.96). The positive correlation had been observed between role adaptation of new nurses and their factors (r=0.307-0.781,P<0.01). The correlation among four factors were good (r=0.340-0.714,P<0.01). The Cronbach′s α was between 0.600-0.903. The correlativity among factors and their items were >0.4 (allP<0.01). Conclusions RAS has good validity and reliability and it is suitable as a scale to evaluate the role adaptation in new nurses.

Objective To explore the expression of interferon-inducible genes (IFIG) in idiopathic inflammatory myopathies (IIM) patients and its clinical significance.Methods Peripheral blood mononuclear cells from 52 IIM patients and 20 healthy controls were extracted.The transcriptional levels of six IFIG genes:oligoadenylate synthetase 1 (OAS-1),IFN-induced protein with tetratricopeptide repeats 1(IFIT1),IFIT4,interferon-inducible-protein 44 (IFI44),radical S-adenosyl methionine domain containing protein 2 (RSAD2) and myxo-virus resistance gene 1 (MX-1) were detected by real-time polymerase chain reaction (PCR).Interferon scores were calculated and compared.The correlations between interferon scores and clinical features of IIM patients were investigated.Non-parametric Mann-Whitney and Spearman analysis were used for statistical analysis.Results In IIM patients,the transcriptional levels of OAS-1 [90.4(40.2,350.8)],IFIT1 [112.7(49.8,151.1)],IFIT4 [127.8(110.4,200.2)],IFI44 [100.3(39.5,160.7)],RSAD2 [100.9(50.2,559.2)] and MX-1 [110.7(60.3,298.9)] were greatly higher than those in healthy controls [4.5(2.1,27.8),21.5(0.4,31.4)i 21.5(0.8,51.2),5.2(0.4,27.8),27.8(17.5,33.5),25.1(15.7,31.8),respectively] (Z=-5.121,-4.359,-5.301,-4.906,-4.348,-4.151; P＜0.01).Meanwhile,interferon scores were significantly elevated in IIM patients [65.7(3.6,136.9),Z=-5.778,P＜0.01],compared with healthy controls [1.2(0.1,3.1)],especially in those with interstitial lung disease [89.3(41.9,176.7),Z=0.544,P＜0.05].Interferon scores were correlated positively with ESR (r=0.234,P＜0.05).Conclusion The mRNA levels of OAS-1,IFIT1,IFIT4,IFI44,RSAD2 and MX-1 are significantly increased in patients with IIM.Interferon score might be used as a new biomarker for IIM patients.

In order to better fulfill the tasks of research,to turn out more quality papers,to produce outstanding results,and to further strengthen management and supervision of scientific research,the"quantitative economic management of scientific research quotas" was established in the hospital.Applying of the measure in scientific research management in the past eight years it was shown that the desired results were achieved,the academic advancement and the personnel growth were greatly promoted.