Tianjin Research Articles

Gender-diverse practitioners in early years education and care (EYEC): a cross-cultural study of Scotland, Hong Kong, and Mainland China

ABSTRACT This paper discusses whether practitioners’ gender subjectivities influence pedagogies and practices in early years education and care (EYEC) settings and whether an increase of men’s participation can improve gender diversity in EYEC. It draws on poststructuralist theories, understanding gender as the product/outcome of the social formation of subjects and the process of subjectification. This is illustrated through accounts for how individual practitioners from Scotland, Hong Kong, and Mainland China discursively construct their gender subjectivities, in accordance with the respective cultural discourses that shape work with young children in EYEC in the three contexts. Thirty-four practitioners from 17 EYEC settings (1 male and 1 female practitioner from each setting) in the cities of Edinburgh, Hong Kong, and Tianjin were interviewed. The study finds that participant practitioners’ constructions of gender subjectivities vary within and across contexts, and gender-binary discourses are to different extents prevalent in all three contexts. This paper argues for a cross-cultural approach to gender-sensitive teacher training, to interrogate popular discourses that advocate for men to fulfil complementary roles in EYEC to women and to challenge gender binary thinking that persists in EYEC and beyond.

Observation on the effect of DMAIC in reducing catheter-related urinary tract infection

Objective To explore the effect of DMAIC(Define, Measure, Analyze, Improve, Control) in reducing catheter-related urinary tract infection. Methods A retrospective case control method was used to select 578 patients admitted and treated in comprehensive ICU of Tianjin First Central Hospital from January to December 2018 with catheters as research objects.The 283 patients from January to June 2018 were the control group, and 295 patients from July to December 2018 were the observation group.Routine methods were used in the control group, and DMAIC method with 6 sigma management was used in the observation group. The correct rate of implementation of each measure, the utilization rate of urinary catheter and the infection rate between the two groups were compared. Results Implementation rate of early extubation assessment, urine collection accuracy, urine tube fixed correctly, urine tube cleaning time, urine collection bags location accuracy were 60.42%(171/283), 69.61%(197/283), 79.86%(226/283), 89.40%(253/283), 92.58%(262/283)in the control group, 80.34%(237/295), 90.85%(268/295), 94.92%(280/295), 96.27%(284/295), 97.97%(289/295) in the observation group, the differences were statistically significant (χ2= 9.411-41.415, P < 0.01). The rate of urinary catheter usage was 75.31%(3 856/5 120) in the observation group and 82.60%(4 098/4 961) in the control group, the differences was statistically significant (χ2=80.475, P < 0.01). The rate of catheter associated urinary tract infection was 0.26‰ (1/3 856) in the observation group and 1.95 ‰ (8/4 098) in the control group, the differences was statistically significant (χ2=5.832, P< 0.05). Conclusions DMAIC can improve the accuracy of nursing measures, optimize the catheter care process, and reduce catheter-related urinary tract infections. Key words: Intensive care unit; Indwelling catheter; Nursing care; Catheter-related urinary tract infection; DMAIC

Clinical efficacy of radical resection for stage T3 gallbladder cancer and prognostic analysis

Clinical efficacy of radical resection for stage T3 gallbladder cancer and prognostic analysis

Placental mesenchymal dysplasia: a case report and literature review

Objective To summarize the clinical, sonographic and pathological characteristics, and the perinatal outcomes of pregnancies complicated by placental mesenchymal dysplasia (PMD). Methods We reported the diagnosis and treatment of a case of PMD in Tianjin Union Medical Center. Pertinent Chinese literatures on PMD were reviewed to analyze the clinical features and the outcomes for mothers and infants. Results (1) Case report: The patient was admitted to our hospital with elevated blood pressure in July 2011 and underwent caesarean section at 30+1 gestational weeks indicated by severe preeclampsia and fetal distress. PMD was diagnosed by placental pathological examination. The patient was discharged from the hospital after oral antihypertensives treatment with stabilized blood pressure. Both the mother and the child were healthy during follow-ups until August 2018. (2) Literature review: A total of 14 cases of PMD were reported domestically including the index case. The average maternal age was 27.9(23-42). Of all the 14 fetuses, half were born alive and half were died in the uterus; two were male, 10 were female and two of unknown sex. Sonographic findings of 10 cases showed thickened placenta with hypoechoic areas. Human chorionic gonadotropin (hCG) was tested in five cases, and the results were all normal. One case was tested for maternal serum alpha fetoprotein (AFP), which was increased. Among the 14 cases, there were two of preeclampsia, six of intrauterine death, three of fetal distress and one of the premature rupture of fetal membranes. Four out of the seven live births were born prematurely. According to the medical record, the average weight of placentas of seven gravidas was 665 g, and eight placentas were larger than the gestational age in size. Pathological examinations showed 11 placentas were covered with grape-like cystic vesicles. No trophoblastic proliferation or stromal trophoblastic inclusion was observed in 12 cases under the microscope. Conclusions PMD is mainly characterized by enlarged and cystic placenta with hypoechoic areas in sonographic findings as well as elevated AFP and normal hCG concentrations in serum. It is more likely to occur in female fetuses with normal karyotype. Placentas with significantly increased size and weight and grape-like cystic vesicles are typical features of PMD that can be detected by pathological examinations. Some gravidas may develop hypertensive disorders of pregnancy and deliver prematurely due to fetal distress, but the maternal and neonatal outcomes are usually good. Close monitoring of the gravidas and fetuses with PMD may help to improve pregnancy outcomes. Key words: Mesoderm; Placenta diseases; Diagnosis, differential; Pregnancy outcome

Landscape pattern analysis and ecological network planning of Tianjin City

Ecological considerations in urban planning stem mostly from the recent sustainable development requirements. In current urban planning, ecological considerations rarely take ecological network structure into account, which often leads to severe landscape fragmentation, poor patch connectivity and serious threats to urban ecological systems. Improving patch connectivity through ecological networks, a minimum cost distance model was proposed for constructing urban ecological corridors and networks and the established urban ecological networks was optimized by setting up foot stones and source points. The establishment of ecological network of Tianjin City was taken as an example. The importance of ecological corridors was further obtained by gravity model. The results showed that the optimized urban ecological network greatly improved on aspects of the city’s corridor connectivity and network closure.

Evaluate the diagnostic performance of three methods in testing heparin induced thrombocytopenia antibodies

Objective Evaluate the diagnostic performance of three methods in testingheparin induced thrombocytopenia antibodies the clinical diagnosis performance of the three heparin induced thrombocytopenia(HIT) antibody testing. Methods 143 patients were collected from the Tianjin Medical university general hospital and China-Japan friendship hospital from the 2017 Sep to 2018 Dec, 67 males and 76 females, with a mean age of (56.1±11.4) years, the pretest probability is estimated to be low (1-3 points) with 24 patients, intermediate (4-5 points) with 79 patients and high(6-8 points) with 40 patients. According to therapeutic regimen, the intermediate and high probability patients were divided into two groups: 31 cases in the heparin discontinuing group and 88 cases in the continuing heparin group. The three methods including:the particle immunofiltration assay to detect the plasma whole HIT antibody; the particle gel immunoassayto detect the plasma whole HIT antibody by ACL TOP 700 coagulation analyzer,; the chemiluminescent immunoassay to detect the plasma IgG-specific HIT antibody by ACL AcuStar chemiluminescent analyzer. Results There was no significant difference between the high and intermediate probability patients for particle immunofiltration assay, particle gel immunoassay and chemiluminescent immunoassay(χ2 was 3.15, 2.89 and 1.31 respectively, P>0.05). The positive rate with three assays were higher in the heparin discontinuing group than the continuing heparin group(χ2 was 16.09, 43.37 and 26.94 respectively, P 0.05) between the continuing heparin group and the heparin discontinuing group for positive results with particle immunofiltration assay; all of the patients with there assays negative simultaneous in the continuing heparin group with a significant difference between the two groups(χ2=14.27, P<0.01). Conclusions Whole HIT antibodies had high sensitivity, and was especially suitable for excluding diagnosis, andthe diagnositic performance withtheparticle gel immunoassay precede the particle immunofiltration assay.For the patients with intermediate or high pretest probability and whole antibodies positive, even if they had been treated with alternative anticoagulant therapy, the IgG specific antibodies(chemiluminescent immunoassay) should be detected for definite diagnosis(if the conditions was appropriate), to verify the rationality of alternative anticoagulant therapy and to avoid overtreatment. Key words: Heparin; Thrombocytopenia; Immunoglobulin G; Predictive value of tests; Sensitivity and specificity

Analysis of different proteins in primary open angle glaucoma based on aqueous proteome

Objective To analyze the changes of protein expression in aqueous humor of patients with primary open angle glaucoma (POAG), and to explore the biological markers and potential therapeutic targets associated with disease occurrence. Methods A retrospective case-control study was adopted.Ten patients with age-related cataract and 10 patients with POAG combined with cataract.were collected at the Tianjin Medical University Eye Hospital from October 2016 to December 2017.In the process of surgery, 100 μl of aqueous humor were collected with 1 ml syringe and No.1 needle through the surgical access.Those proteins extracted from aqueous humor were analyzed by quantitative proteomic mass spectrometry.The differential significance test was performed by Maxquant significances A. The differential proteins of the two groups were screened and determined with the conditions of P 2.The biological big data was annotated by the function of GO and KEGG.The study was approved by the Ethics Committee of the Tianjin Medical University Eye Hospital (No.2013KY[L]-10). Patients and their guardians all signed the informed consent. Results Ninty-seven differential proteins were detected in this proteomic analysis, including 48 up-regulated proteins and 49 down-regulated proteins.GO analysis significantly differs in protein function involved in many aspects, some different proteins including lipopolysaccharide-binding protein (LBP), cluster of Differentiation 163(CD163), C-reactive protein (CRP), annexin A1 (ANXA1) were involved in inflammation; redox-related proteins were glutathione S-transferase P (GSTP1), thioredoxin (TXN), some different proteins related with cell adhesion movement were cartilage oligomeric matrix protein (COMP), desmocollin-2 (DSC2) and laminin subunit beta-2 (LAMB2); procollagen-lysine, 2-oxoglutarate 5-dioxygenase 1 (PLOD1), solid protein (tenascin, TNC) are associated with fibrosis; some different proteins related to nerve growth were reelin (RELN), semaphorin-3F(SEMA3F), semaphorin-4B(SEMA4B). Metabolism-related proteins included pyruvate kinase (PKM), carb oxypeptidase N subunit 2 (CPN2) and so on.KEGG analysis indicated that the expression of NrF2/ERK signaling pathway and TGF-β/NF-κB signaling pathway were different between the two groups. Conclusions The expression of GSTP1 and TXN in the aqueous humor of POAG is significantly decreased, which may regulate cell adhesion and activity and expression of extracellular matrix by regulating NrF2/ERK1/2 and TGF-β/NF-κB signaling pathways.GSTP1 and TXN may serve as a potential biomarker and therapeutic target of POAG. Key words: Primary open angle glaucoma; Aqueous humor; Label free quantitative proteome; Glutathione S-transferase P; Thioredoxin; Transforming growth factor-β; nuclear factor-kappa B; Nuclear factor erythroid 2-related factor 2; extracellular regulated protein kinases

Ocular surface damage in dry eye patients with seborrheic dermatitis

Objective To observe the ocular surface function changes of dry eye patients with seborrheic dermatitis and discuss the significance of seborrheic dermatitis in ocular surface damage. Methods A cohort study was performed.Forty-nine patients (49 eyes) who were initial diagnosed with dry eye enrolled in General Hospital of Tianjin Medical University from October 2015 to March 2016 were divided into 2 groups, including 21 patients with seborrheic dermatitis and 28 patients without seborrheic dermatitis.Gender, age, meibomian gland dysfunction (MGD), eyelid margin scores, eyelid secretions scores, meibomian gland imaging scores, conjunctival congestion scores, ocular surface disease index (OSDI), Schirmer Ⅰtest (SⅠt), break-up time of tear film (BUT), fluorescent integral score were examined and compared.The study was followed the Declaration of Helsinki and was approved by General Hospital of Tianjin Medical University (No.IRB2015-YX-069). Written informed consent was obtained from all subjects before entering the study. Results There were not significant differences in gender and ages (χ2=1.536, P=0.215; t=0.642, P=0.524). The rate of MGD in seborrheic dermatitis group was 57.15%, which was significantly higher than that in the non-seborheic dermatitis group (25.00%), with significan difference between the two groups (χ2=5.222, P=0.022). There were significant differences in eyelid margin scores, eyelid secretions scores, meibomian gland imaging scores, fluorescent integral scores between the two groups (Z=2.105, 3.303, 3.368, 3.036, all at P<0.05). The OSDI in the seborheic dermatitis group was 26.43±8.05, which was significantly larger than that in the non-seborheic dermatitis group (16.75±5.74); the BUT in the seborheic dermatitis group was (6.14±1.98)s, which was significantly shorter than that in the non-seborheic (8.75±1.38)s (t=4.918, 5.434; both at P<0.05). Conclusions Seborrheic dermatitis may aggravate ocular surface dysfunction in dry eye patients. Key words: Ocular surface damage; Seborrheic dermatitis; Dry eye; Meibomian gland dysfunction

Numerical study on the winter thermal performance and energy saving potential of thermo-activated PCM composite wall in existing buildings

The pipe-embedded building envelope is heavyweight thermally activated building systems (TABS) that has its pipe circuits inside building envelopes, but it has been seldom done in existing buildings. In this context, the concept of thermo-activated phase change material composite wall (TAPCW) is proposed to address the retrofitting challenges facing existing buildings, that is to substitute the pipe-embedded interlayer with macro-encapsulated PCM panel and relocate it to the exterior of the load-bearing layer. This work aims to investigate the thermal and energy saving performances of TAPCW under the winter climate conditions of northern China (i.e, Tianjin city) through a validated numerical model. Furthermore, performances of TAPCW are examined for some key factors, including the pipe spacing, PCM thickness, and orientation. The comparative study of three cases (case 1: TAPCW; case 2: normal wall integrated with PCM; and case 3: normal wall) verifies the effectiveness of TAPCW, and the daily heat loss (Groom), primary energy consumption (PE) and operation cost (C) can be reduced by 105.5%, 14.07%, and 56.03%, respectively. The parametric study shows that the pipe spacing has a more obvious influence than the PCM thickness, and the case 100/30 could be used as an optimum value for thermal barrier function, while the case 75/30 could provide a more efficient supplementary heating. Results also show that the TAPCW applied in the north orientation is more effective, which has the highest value of interior temperature increase (1.8 °C), effective PCM utilization ratio (14.14%), reduction size of PE (64.98%) and reduction size of C (34.43%). Overall, the proposed TAPCW presents a satisfactory thermal behavior in the heating season and could contribute to the progress of energy saving retrofit in the vast existing buildings.

Spatiotemporal evolution pattern detection for heavy-duty diesel truck emissions using trajectory mining: A case study of Tianjin, China

Abstract Emissions from heavy-duty diesel trucks (HDDTs) pose a major threat to environment and human health. Understanding the behavior of pollutant emissions from HDDTs facilitate the formulation of traffic-related policy measures to mitigate the adverse effects. This study proposes a new method to estimate the emission inventory of HDDTs and analyze their spatiotemporal evolution characteristics. Multi-source data were fused to provide a complete picture of the transport environment. With the idea of modeling pollutant emissions by “single vehicle” and “road segment,” emission inventories were constructed with different spatiotemporal scales using localized emission factors. A spatiotemporal cube model was introduced to represent the high-resolution emission inventory. A hot-spot and local-outlier analysis were conducted to explore the spatiotemporal evolution mechanism of pollutant emissions. The megacity of Tianjin in China was taken as the area for the case study. The average daily emissions of CO, NOx, PM, and VOC are 12,978.18, 48,675.22, 712.6, and 1217.72 kg d−1, respectively. Temporally, the pollutant emission had a significant peak at 06:00, 11:00, and 18:00 and was affected by major festivals. Spatially, the distribution pattern of emission was policy-driven and closely related to its spatial location. It increases radially outward from the outer-ring road to the periphery. The hot-spot analysis identified 16 pollutant emission patterns. The road segment with persistent cold spots accounted for 48.27% of the roads, mainly distributed within the outer ring road. The road segments with intensifying and persistent hot spots accounted for 19.04% of roads, mainly distributed on the intercity highway. The locations with outlier values reached 12,027, accounting for 31.90%. The key time intervals of the occurrence of the outlier pattern are 11:00–12:00 and 01:00–02:00. Road segments showing only the low–low cluster pattern is mainly located within the outer ring roads. Those with only low–high outlier pattern exhibits a relatively scattered spatial distribution, which is affected by the heterogeneous distribution of HDDTs.

Selection and application of spatial variability distribution function of soil moisture in farmland

In order to find a method for reasonably determining the number of soil moisture monitoring points (depth 0-20, 20-40, 40-60 cm at per points) in the farmland scale, in Beijinzhuang village and Xilv village of Cui Huangkou town, Wuqing district, Tianjin city. The monitoring area (286.67ha). Monitoring stations is divided into three layers from southeast to northwest. The soil moisture content of 61 points was measured in turn. The parameters were fit analysis based on the obtained data by using P-III type distribution function and normal distribution function. The minimum sample size of the measured sequence was analyzed. The analysis results show that the P-III type distribution function (correlation coefficient R2=0.9954, average relative error is 6.3%) is better than the normal distribution function (correlation coefficient R2=0.9918, average relative error is 6.6%), but the two are very close. Therefore, the number of reasonable soil moisture monitoring points were determined by the normal distribution function . the number of samples of the measured sequence, by which determining the reasonable soil moisture monitoring points in the farmland scale, should not be less than 30 points.

Plant community structure and species diversity in Lingang wetland park in Tianjin China

Lingang wetland park is a newly built wetland park in Lingang district, Tianjin, China. The community composition, community structure, frequency of occurrence of arbor and shrub layer and dominant species of plant community in lingang wetland park were investigated. The results showed that the community of Lingang wetland park was mainly characterized by the structure of trees-shrubs-lawns, and the ratio of species and number of evergreen trees to deciduous trees was 2:15 and 1:23. Wetland park is rich in plant diversity, the dominance index at park's east gate and “qushuihuajing” were 0.8183 and 0.8152, which were far higher than other quadrants and the dominant species is golden elm. Among the tall trees, Ulmus pumila, Salix babylonica, Aureus locustae with the highest application frequency accounted for 23.8%. For shrubs, lonicera japonica, Euonymus japonicus and Lonicera maackii had the highest frequency of application. Festuca elata and Hemerocallis fulva had highest application frequency in lawns. They accounted for only 13.2% in herbs. It indicated that only several plants in the park have high frequencies.

Comprehensive Evaluation of Economic Development Level of Beijing, Tianjin and Hebei Cities Based on TOPSIS Method

Comprehensive Evaluation of Economic Development Level of Beijing, Tianjin and Hebei Cities Based on TOPSIS Method

Risk factors analysis for developing diabetes based on its 3-year outcome in an elderly population with impaired fasting glucose

To examine the risk factors for developing diabetes on its 3-year outcome in an elderly population with impaired fasting glucose (IFG). We selected the 328 elderly with impaired fasting glucose in Binhai new area of Tianjin as the research object. All subjects participated in objective examinations such as physical activity ability tests, blood tests and anthropometric examinations, and completed the questionnaire survey. Between baseline and 3-year outcome, 56 of the subjects with IFG at baseline have developed diabetes. After multivariate adjustments, we found that higher incidence of diabetes was associated with higher fasting plasma glucose (OR=9.30, 95%CI 2.84-30.48, P<0.01) and reduced grip strength/weight (OR=0.88, 95%CI 0.82-0.94, P<0.01). Moreover, the combination of higher fasting plasma glucose and lower grip strength/weight would lead to higher incidence of diabetes compared with higher fasting plasma glucose or lower grip strength/weight alone (P<0.05). In this study, high fasting plasma glucose and low muscle strength were associated with blood glucose worsening in three years in IFG patients. In addition to blood glucose levels, physical activity is also a risk factor for diabetes in older adults. Key words: Impaired fasting glycaemia; Muscle strength; Elderly

Diagnosis of primary osseous malignant tumors with 18F-FDG PET/CT in patients over 40 years old

Objective To investigate the value of 18F-fluorodeoxyglucose (FDG) PET/CT in the diagnosis of different pathological types of primary osseous malignant tumors (POMT) in patients over 40 years old. Methods Fifty-two patients (30 males, 22 females, median age: 60(41-81)years) with POMT who underwent 18F-FDG PET/CT and were pathologically confirmed from January 2013 to May 2018 in Cancer Hospital of Tianjin Medical University were reviewed. The region of interest was drawn and the standardized uptake value (SUV) was automatically measured. The SUV in different pathological types of POMT was compared using one-way analysis of variance or two-sample t test. Results The 52 POMT included 22 sarcomas, 16 isolated myelomas (IM), and 14 primary bone lymphomas (PBL). The SUV in PBL was significantly higher that than in sarcomas and IM with the maximum SUV (SUVmax) of 21.6±12.4, 13.5±7.7 and 9.0±6.4 respectively(F=7.56, P<0.01), and the mean SUV (SUVmean) of 12.9±7.8, 7.5±4.5, and 5.6±4.4, respectively(F=6.92, P<0.01). In the sarcoma group, the SUV of undifferentiated sarcomas was significantly higher than that of other well-differentiated sarcomas (SUVmax: 21.1±5.4 vs 11.3±6.9, SUVmean: 11.8±3.3 vs 6.3±4.1; t=-2.92, -2.71, both P<0.01). The growth pattern of sarcomas and IM was different on CT images. Conclusions The FDG uptake of PBL is higher than that of other pathological types. CT features are helpful for the differential diagnosis of POMT in 18F-FDG PET/CT. Key words: Bone neoplasms; Middle aged; Aged; Positron-emission tomography; Tomography, X-ray computed; Deoxyglucose

Research on the method of three-dimensional surface displacements of Tianjin area based on combined multi-source measurements

Abstract Combining multi-source measurements can improve the accuracy and the spatial resolution of the three-dimensional (3-D) displacements field. Few researches have been conducted to integrate InSAR, GPS and leveling data of Tianjin in the recent three years to get the 3-D large displacement velocity field. How to effectively combine multi-source measurements and obtain the accurate 3-D large displacement field in high spatial resolution is worth studying. In this paper, the optimal method for acquiring 3-D displacement field by combining InSAR, leveling and GPS measurements is obtained by comparing the different methods. Then we realize the combining InSAR, leveling and GPS measurements to obtain the high-precision 3-D displacement field in Tianjin (China) from 2016 to 2018. Compared with different methods, we integrate InSAR, GPS and leveling measurements and use the weighted least squares method to estimate the 3-D displacement field with the highest accuracy. Although the accuracy of the horizontal displacement field obtained by this method has not been greatly improved, the vertical accuracy is obviously better than the other methods. The introduction of leveling measurements is beneficial to improve the accuracy of the vertical displacement field. Compared with independent GPS measurements, the standard deviations of 3-D displacements velocity field estimated by optimal solution method is 2.6 mm/yr, 2.1 mm/yr and 2.7 mm/yr in the vertical, eastern and northern directions, respectively. These results indicate that this method effectively utilizes the advantages of GPS, InSAR and leveling measurements, and extends the limitations of a single technical in describing surface-time scale applications. And the 3-D displacements information with a large spatial scale and high spatial resolution provides a reliable data basis for studying the crustal movement and its dynamic mechanism in China.

A risk assessment model for esophageal varices occurrence based on endoscopic ultrasonography

Objective To identify the independent risk factors of esophageal varices (EV) in cirrhosis by endoscopic ultrasonography (EUS), and further to establish a risk assessment model for predicting EV occurrence and evaluate the clinical predictive value of the model. Methods A retrospective cohort study was used in this study. Data of patients with cirrhosis without varicosity, who were hospitalized in Tianjin Second People's Hospital from September 2014 to March 2017 were collected. The location, diameter, and number of esophageal collateral circulation were measured by EUS. The non-selective beta blocker (NSBB) medication history and antiviral therapy were recorded. The time of the first EUS examination was taken as the starting point and the follow-up period was set up as 18 months. The end point was the occurrence of EV or the end of follow-up. The independent risk factors of EV occurrence were determined by univariate and multivariate logistic regression analysis, and the risk assessment model of EV occurrence was constructed. The predictive value of evaluation model for disease was studied by ROC analysis. Hosmer-Lemeshow goodness of fit was used to test the fitting efficiency of the evaluation model. Results A total of 638 subjects were recruited initially, 13 of them were lost in the course of the study. Finally, 625 cases were included in the study. Among them, 369 cases did not develop EV (the non-progress group) and 256 cases developed EV (the progress group). (1) Multivariate logistic regression analysis showed that 7 independent risk factors were selected into the risk assessment model of EV occurrence, and were assigned corresponding scores: no NSBB (3 points), no antiviral treatment (2 points), Child-Pugh stage B (1 point), the diameter of peri-ECV>2 mm (1 point), the number of peri-ECV≥5 (3 points), the diameter of para-ECV≥5 mm (4 points), and the number of para-ECV≥5 (4 points). (2) In the risk assessment model, the risk factor scores ranged from 1 to 4 with a total score of 0-18. The predicted incidence of EV increased from 0.003 to 1.000 with the increase of the score. (3) In the risk assessment model, the total risk score ≤2 was assigned into low-risk group, 3-5 into medium-risk group, and ≥6 into high-risk group. The actual EV incidence of each risk stratification was 2.78% in the low-risk group, 36.36% in the medium-risk group and 93.91% in the high-risk group, respectively. (4) The ROC analysis showed that area under curve (AUC) was 0.947 (P<0.05), suggesting that the risk assessment model had a good effect on predicting disease progression. Hosmer-Lemeshow test showed that P was 0.450, suggesting that the model fitted well. Conclusion The risk assessment model based on EUS can accurately predict the occurrence of EV, and is simple and easy to use. The model can provide scientific basis for the prevention and rational treatment of EV in liver cirrhosis. Key words: Liver cirrhosis; Varicose veins; Endosonography; Logistic models

Differences in starting points of active phase and labor duration between preterm and full-term primiparae

Objective To compare the starting points of the active phase of labor and labor duration between preterm and full-term primiparae and to provide evidence for appropriate labor management. Methods From January 2013 to December 2016, 925 preterm primiparae (preterm group, 28 to 36+6 weeks) and equal number of full-term primiparae (full-term group, 37 to 41+6 weeks) who delivered in Tianjin Central Hospital of Gynecology Obstetrics were recruited. The starting point of the active labor was defined as the cervical dilatation at the turning point on the cervical dilatation curve where changing from almost flat to the biggest slope. Differences in the starting points and labor duration between the two groups were compared. Statistical analysis was performed using two independent sample t-test, one way analysis of variance and rank-sum test. Results The duration of the first and second stages [(5.7±2.5) vs (6.8±5.2) h, t=-5.835; (29.9±16.8) vs (34.2±17.2) min, t=-12.637; both P 6 cm of cervical dilatation were 74 (8.0%), 208 (22.5%), 287 (31.0%), 168 (18.2%), 127 (13.7%) and 61(6.6%), respectively. In the preterm group, the starting points of the active phase at cervical dilatation≤3 cm, ≤4 cm and ≤5 cm accounted for 60.3% (558/925), 82.3% (761/925) and 94.1% (870/925), respectively. In the full-term group, the percentages of the active phase starting at cervical dilatation≤4 cm, ≤5 cm and ≤6 cm were 61.5% (569/925), 79.7% (737/925) and 93.4% (864/925), respectively. Conclusions Preterm primiparae may experience shorter labor duration and an earlier start of the active phase than full-term primiparae. The routine labor progression model for full-term primiparae should not be applied to preterm primiparae. Key words: Obstetric labor, premature; Term birth; Labor, obstetric; Fetal monitoring; Labor stage, first; Labor stage, second

Calculation and Evaluation of Spatial Layout of Circum-Bohai Sea City Innovation Industrial Parks Based on City-Industry Integration

Zhang, W.; He, S.-Y.; Jiang, L.-K.; Huang, J.-B.; Tang, C.-J., and Xu, K.-Y., 2019. Calculation and evaluation of spatial layout of circum-Bohai Sea city innovation industrial parks based on city-industry integration. In: Gong, D.; Zhu, H., and Liu, R. (eds.), Selected Topics in Coastal Research: Engineering, Industry, Economy, and Sustainable Development. Journal of Coastal Research, Special Issue No. 94, pp. 732–737. Coconut Creek (Florida), ISSN 0749-0208.This paper takes the layout of innovation industrial parks in Tianjin City, the economic center of circum-Bohai Sea region, as the research object. At first, based on relevant theoretical research, the paper proposes that the design of the layout evaluation indicators of the innovation industrial parks should follow the system optimization principle and the availability principle. Second, after a discussion on the alternative calculation methods, this paper selects the factor analysis and the entropy method as the main calculation methods, and investigates the inadequacies of these methods. Third, a corresponding evaluation and analysis indicator system is designed; 4 first-level indicators of location factor, infrastructure, innovation ability and social contribution, and 12 second-level indicators are devised to form an evaluation indicator system for layout of the innovation industrial parks in Tianjin; after calculation, objective comprehensive evaluation results are obtained and interpreted. Fourth, multi-criteria and multi-dimensional comparative analysis is carried out to analyze the development of these innovation industrial parks in Tianjin; and the conclusion is that the location advantage and the development status are the main factors affecting the layout of the innovation industrial parks in coastal areas. At last, from the perspective of national and related industries, combined with the results of evaluation and analysis, this paper proposes comprehensive spatial layout recommendations for the problems existing in the layout of innovation industrial parks in Tianjin from aspects of infrastructure, location advantage, and future development trends, etc.

Analysis of drug resistance and risk factors of community-acquired urinary tract infection caused by extended-spectrum β-lactamase-producing Escherichia coli in children

Objective To investigate the drug resistance and risk factors of community-acquired urinary tract infection(UTI) caused by extended-spectrum β-lactamase(ESBLs)-producing Escherichia coli in children. Methods The clinical data of 125 children with community-acquired urinary tract infection caused by Escherichia coli were analyzed, who were hospitalized at Department of Pediatric Nephrology of Tianjin Children′s Hospital from June 2017 to June 2018.The ESBLs-producing group and the non ESBLs-producing group were named depending on the production of the ESBLs.WHONET 5.6 bacterial resistance monitoring software was used to calculate the drug resistance rate of bacteria.The drug resistance rate and clinical data were analyzed by adopting χ2 test and Fisher′s exact probability method, then, factors with statistical significance identified by single factor analysis were further analyzed by multivariate Logistic regression analysis. Results Among 125 strains of Escherichia coli, 68 strains(54.4%) were ESBLs-producing Escherichia coli and 57 strains(45.6%) were non ESBLs-producing.The drug resistance rates of ESBLs-producing Escherichia coli to penicillins, cephalosporins, quinolones and monocyclic beta-lactams were higher than those of non ESBLs-producing strains, and the drug resistance rates to Ampicillin, Piperacillin, Cefazolin, Cefuroxime, Ceftriaxone and Cefotaxime were nearly 100%.The resistance rates of ESBLs-producing strains to Imipenem, Meropenem, Amikacin, Furantoin, Cefotetan and Piperacillin/Tazobactam were lower (< 5%). Univariate analysis showed that there were significant differences in recurrent UTI (χ2=12.043, P<0.01) and use of third-generation cephalosporins in the past 3 months(χ2=28.545, P<0.01) between ESBLs-producing group and non ESBLs-producing group.Multivariate Logistic regression analysis showed that use of third-generation cephalosporins in the past 3 months was an independent risk factor of community-acquired UTI caused by ESBLs-producing Escherichia coli(OR=11.285, 95%CI: 3.140-39.134, Wald=13.972, P<0.01). Conclusions The isolation rate of ESBLs-producing Escherichia coli in children with community-acquired UTI is high, and the drug resistance rate is high, so children who used third-generation cephalosporins in the past 3 months were more likely to develop community-acquired UTI caused by ESBLs-producing Escherichia coli. Key words: Urinary tract infection; Escherichia coli; Extended-spectrum β-lactamase; Child