Objectives: To investigate the clinical application values of procalcitonin (PCT), high-sensitivity C-reactive protein (hs-CRP) and serum amyloid A (SAA) in the early diagnosis of sepsis. Methods: In this retrospective analysis, 36 patients admitted to Liaocheng People’s Hospital were selected from May 2018 to July 2019. According to infectious disease diagnostic criteria, 17 patients were confirmed to have sepsis (observation group), and 19 patients were determined to be nonseptic (control group). The levels of PCT, CRP and SAA of patients were detected on admission, and the clinical application values of PCT, CRP and SAA for sepsis were compared. Results: Seventeen patients were included in the observation group, including 9 males and 8 females, with an average age of 52.18 ± 9.49 years; 19 patients were included in the control group, including 12 males and 7 females, with an average age of 51.53 ± 8.50 years. On admission, there were significant differences in white blood cell (WBC) count (t = 5.134), neutrophil count (t = 3.143), lymphocyte count (t = 2.510), PCT (t = 9.250), hs-CRP (t = 2.947) and SAA (t = 11.360) between the observation group and the control group, and the differences were statistically significant. For the comparison of clinical application values: the sensitivity of PCT, hs-CRP and SAA was 78.95%, 52.17% and 50.00%, respectively; the specificity of PCT, hs-CRP and SAA was 88.24%, 61.54% and 37.50%, respectively; the area under the ROC curve (AUC) of PCT, hs-CRP and SAA was 0.920, 0.684 and 0.870, respectively; the logistic regression coefficient of PCT, hs-CRP and SAA was -0.577, -0.028 and -0.009, respectively; and the 95% confidence interval (CI) of PCT, hs-CRP and SAA was 0.779-0.985, 0.508-0.828 and 0.716-0.958, respectively. Conclusion: Compared with hs-CRP and SAA, PCT had a higher clinical application value for sepsis, and PCT could be used as a reliable index for the early diagnosis of sepsis. doi: https://doi.org/10.12669/pjms.36.7.2544 How to cite this:Sui Y, Xin W, Feng L. Comparison of the clinical application values of PCT, hs-CRP and SAA detection in the early diagnosis of sepsis. Pak J Med Sci. 2020;36(7):---------. doi: https://doi.org/10.12669/pjms.36.7.2544 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Aims To make the evaluation more scientific, structured and systematic, this study aims to develop an evaluation index system for nurses training and to explore clinical effect of system. Design The evaluation index system of nurses’ post‐training was constructed using the Delphi method. Methods Introducing the system, we used the pre‐work training of new nurses as an example for discussing the specific implementation scheme of the system. Twenty‐five tertiary and first‐class general hospitals in 14 provinces and municipalities were evaluated on the spot, and the application effect of the system was evaluated comprehensively. Results The index system consisted of three first‐grade indexes, seven second‐grade indexes and 23 third‐grade indexes. There were three levels in teaching and training ability, and the distance had statistical significance.

ObjectiveTo analyze the predictive value of renal resistance index (RRI) and plasma cystatin C (pCysC) in pregnancy-related acute kidney injury (PR-AKI).MethodsThis study included 182 pregnant women admitted to the intensive care unit (ICU) between May 2016 and June 2021. Intensivists who had received full-time bedside ultrasound Doppler training performed RRI measurements, and blood was drawn to monitor serum creatinine (Scr) and pCysC concentrations. The study continued for 3 consecutive days, marked as the first day, the second day, and the third day, during which the hourly urine output (UO) was monitored and recorded. According to the AKI diagnostic staging criteria, patients with AKI were divided into stages I, II, and III and comprised the study group (Group A), and patients without AKI served as the control group (Group B).ResultsOf the 182 enrolled patients, 35 (19.2%) were diagnosed with AKI, including 23 (65.7%) with stage I, 9 with stage II (25.7%), and 3 with stage III (8.6%). Three were excluded owing to the requirement of continuous blood purification. Therefore, 179 patients, 32 in Group A and 147 in Group B, were included. The Scr, pCysC, and RRI of Group A increased on the first, second, and third days, but there was a gradual decrease over time. Each period was compared with the corresponding period in Group B, and there were significant differences (P<0.05). All patients in Group A met the diagnostic criterion of Scr concentration in AKI, and only 34.4% of the patients met the diagnostic criterion of UO. According to the D1 monitoring results, the proportions of increased pCysC and RRI in Group A were 87.5% and 81.3%, respectively. They were significantly different from those in Group B (P<0.001). The three variables of pCysC, RRI, and the combination of pCysC and RRI all independently correlated with AKI. The sensitivity and specificity of pCysC concentration for the prediction of PR-AKI were 87.5% and 84.35%, respectively, and those of RRI were 81.25% and 76.87%, respectively. The sensitivity and specificity of the combination of the two were 96.88% and 72.11%, respectively. Receiver operating characteristic curve analysis showed that these indicators had a significant predictive power for PR-AKI. Although the length of stay in the ICU and hospital in Group A was longer (P<0.05), there was no difference in hospital mortality between the two groups (P>0.05).ConclusionThe diagnosis of PR-AKI based only on Scr and UO was insufficient. RRI and pCysC were important supplements for diagnosing PR-AKI, with good sensitivity and specificity. However, combining the two was better.

No abstract