Objective To evaluate the effects of nutritional intervention on the incidence of malnutrition in patients on maintenance hemodialysis (MHD).Methods Totally 196 patients on MHD were randomly assigned to nutritional intervention group (n =98) and control group (n =98).Nutritional intervention or free diet were given in these two groups.The incidence of malnutrition in these two groups was recoded.Results The baseline age,biochemical indicators,and incidence of malnutrition were matched in these two groups (P ＞0.05).After 6 months,although the number of the patients with malnutrition [35.7％ (35/98)] was slightly increased in the intervention group,it showed no significant difference when compared with the baseline level [33.7％ (33/98),P ＞0.05].In the control group,however,the incidence of malnutrition [59.2％ (58/98)] significantly increased (P ＜0.05).The incidence of malnutrition was significantly lower in the intervention group than in the control group (P ＜ 0.05).Conclusion Nutritional intervention can lower the incidence of malnutrition in patients on MHD.

Objective To investigate the correlation between atypical respiratory pathogens infection and serum vitamin D(VitD) level in children.Methods Serum IgM antibody levels of 11 atypical respiratory pathogens were detected in 414 serum samples of child respiratory infection by using the respiratory tract 11-items detection reagent kits (indirect immunofluorescence assay),including respiratory syncytial virus(RSV),adenovirus(ADV),influenza A virus(FluA),influenza B virus(FluB),parainfluenzavirus(PFlu),Mycoplasma pneumonia(MP),Chlalmydia pneumoniae(CP),Coxsackie virus type B(CoxB),Coxsackie virus type A(CoxA) and legionella pneumophilia(LP).At the same time the electrochemiluminescence assay was used to measure serum VitD level.Results Among 414 samples,pathogen IgM was detected out in 214 samples (51.69%),the top three places of detection rates were FluB,FluA and Mp,their positive rates were 32.13%,23.19% and 13.77% respectively;in cases of positive IgM antibody,17.63% of children developed single infection,34.06% of children developed 2 kinds of pathogen or more mixed infection;there was no statistical difference in the VitD levels between the IgM antibody positive group (median 23.60 ng/mL,3.37-71.50 ng/mL) and the IgM antibody negtive group(median 23.95 ng/mL,3.00-81.70 ng/mL).The IgM antibody positive rate,single infection positive rate and mixed infection positive rate had no statistical difference between the VitD reduce group and the VitD normal group(P>0.05).The positive rate of FluB,FluA and MP IgM antibody had no statistical difference between the VitD reduce group and the VitD normal group(P>0.05).Atypical respiratory pathogens had no correlation with VitD(r=0.005,P=0.912).Conclusion Atypical respiratory pathogens infection may had no correlation with the VitD level reduce.

Objective? To investigate the occurrence and influencing factors of falls in elderly patients with knee osteoarthritis (KOA), and provide scientific reference for the prevention of falls in elderly patients with KOA. Methods? Using convenience sampling method, 104 elderly patients diagnosed as KOA in orthopaedic wards of four ClassⅢ Grade A hospitals in Hangzhou from November 2017 to August 2018 were selected as subjects. General Information Questionnaire, Morse Fall Scale(MFS)and the Barthel Index(BI)for Activities of Daily Living (ADL) were applied in the investigation. Single factor analysis and multiple factor Logistic regression were used to analyze the influencing factors of falls in elderly KOA patients. Results? A total of 104 questionnaires were sent out in this study, and 95 valid questionnaires were recovered, yielding an effective recovery rate of 91.35%. The incidence of falls in elderly KOA patients was 45.26% (43/95), of which 62.79% (27/43) had fallen twice or more. There were significant differences in knee injury history, staircase climbing and falls among elderly KOA patients (P＜ 0.05). There were significant differences in the risk of falls between elderly KOA patients in "whether taking drugs", "whether using walking aids", "status of self-care ability", and "age" (P＜ 0.05). Logistic regression analysis showed that history of knee injury, frequent staircase climbing and use of walking aids were the influencing factors of falls in elderly KOA patients (OR=4.028, 25.569, 3.191; P＜ 0.05). Conclusions? In view of the influencing factors of falls in elderly KOA patients, individualized nursing measures should be taken to strengthen falls risk assessment, carry out fall prevention related education and improve patients' social support, which will help to reduce the incidence of falls and further improve patients' quality of life.