From the view of ergonomics study,the importance of optimized design for human-computer coordination work is presented. Through the analysis of probably reasons for the ergonomics accidents in the process of human-computer coordination work,the methods and realization of the optimized design are given out. Furthermore,the studies of human-computer systematization design in preventing the accidents are also discussed.

Objective To establish and evaluate a diagnostic technique based on the AllGlo~(TM) probe for the invasive aspergillosis. Methods With the self-designed AllGlo~(TM) probes and primers and the standards, two standard curves of the real-time PCR based on AllGlo~(TM) probes were established respectively for A. flaws and A. fumigatus,then its specificity, sensitivity and reproducibility were evaluated respectively. Results The findings indicated that the standard curve of A. flavus was Y = - 3. 003X + 36. 825, and A. fumigatus' was Y = - 3. 052X + 38.016, and their interassay coefficient of variation respectively were 15.60% and 12. 94% , suggesting a good reproducibility. The lowest spore concentration they could be detected was 10 CFU/ml, which equated to 100-1000 copies of internal transcribed spacer (ITS)2 genes, suggesting a good sensibility. They didn't have cross-positive reaction with other fungus, human genome and bacteria, which indicated a good specificity. Conclusion The diagnostic technique based on the AllGlo?probe for the invasive aspergillosis possessed a good sensitivity, good specificity and deadly accuracy.

Objective To investigate the effect of resistance nodulation division (RND) efflux pumps on reduced susceptibility to tigecycline in carbapenem-resistant Acinetobacter baumanii.Methods Totally 631 isolates of Acinetobacter baumanii were collected from 16 hospitals in 7 provinces in 2010.Genes oxa-51 and oxa-23 were detected by PCR method,and the ST profiles were determined by multilocus sequence typing (MLST).The disk susceptibility assay was used to determine the inhibition zone diameters of β-lactams,aminoglycosides,macrolides,tetracyclines,carbapenems,tigecycline and polymyxin.The minimum inhibitory concentration (MIC) of tigecycline was determined by E-test in strains with inhibition zone diameters ≤ 12 mm on tigecycline.The expression of operon genes adeB,adeG and adeJ was determined with efflux pump inhibitor NMP (N-methyl-2-pyrrolidone) for detection of efflux pump inhibitor phenotype.The isolates of Acinetobacter baumanii which were resistant both to tigecycline and carbapenems and with the inhibited phenotype of efflux pump inhibitor were collected as the experiment group,the isolates which were susceptible to tigecycline but resistant to carbapenems were collected as the control group,and ATCC 19606 was used as the reference strain.The expressions of adeABC,adeFGH and adeIJK were quantified by q-PCR at the transcriptional level.Genes adeR,adeS and adeL were amplified and sequenced using PCR method to find polymorphic locus and insertion sequences.Results There were 32 isolates of Acinetobacter baumanii with reduced susceptibility to tigecycline and carbapenem-resistant.Eight isolates were with the inhibited phenotype by efflux pump inhibitor.And 4 strains which were susceptible to tigecycline but resistant to carbapenems were selected as the control.The expressions of adeABC in A518,Z1219 and A527 of experiment group were 13-fold,5-fold and 7-fold higher than reference strain ATCC19606,respectively.The expressions of adeFGH and adeIJK were up-regulated slightly in some isolates.Transcript of adeABC was not found in control group strains A207 and A1731,and the expressions of adeABC,adeFGH and adeIJK were not up-regulated in other isolates.The single nucleotide polymorphism (SNP) was detected in adeR (E220K) and adeS (A130D),respectively.ISAab1 insertion sequence was identified in adeS of adeABC-over expressed isolates.No mutation was found in adeL.Conclusion High expression of adeABC pump may play an important role in tigecycline resistance in carbapenem-resistant Acinetobacter baumannii,mainly due to the insertion of ISAba1 sequence in its regulator gene adeS,but other mechanism of tigecycline resistance may not be excluded.

Objective To assess the risk factors of intradialytic-hypotension (IDH) and the prognosis of IDH among maintenance hemodialysis (MHD) patients for the prevention and treatment of IDH.Methods 276 MHD patients were enrolled during Jan.2009 to Mar.2009.Intradialytic blood pressure was monitored during a 3-month period.IDH was defined as an event characterized by a sudden drop in systolic BP more than 20 mmHg or in mean artery pressure (MAP) more than 10 mmHgassociated with clinical events and need for interventions.Dialysis-related information was collected.Kaplan-Meier method,log-rank test,logistic regression and Cox regression analyses were performed to examine the association between IDH and survival,using a follow-up through 31 May 2014.Results A total of 276 patients were recruited.The incidence rate of IDH was 40.9％.163 patients with no-IDH (＜ 1/10 hypotensive events/3 months) served as controls.113 patients with IDH (≥ 1/10 hypotensive events/3 months) were identified among all 276 patients.Multivariate logistic regression analysis showed that age,ultrafiltration rate,gender,serum NT-proBNP,serum albumin and aortic rool inside dimension (AoRD) were associated with IDH among MHD patients.During the 5-year follow-up,74 patients died,with a mortality rate 5.2 per 100 person-year.Kaplan-Meier survival curve showed significant difference of overall and CV mortality rates between 2 groups.The multivariate Cox regression model indicated that IDH increased the risk of death (HR=1.572,95％CI 1.077-2.293,P=0.019).So did the rise of LVMI (HR=1.010,95％CI 1.009-1.085,P=0.020).Conclusion Elderly,female,high ultrafiltration rate,high level of serum NT-proBNP,hypoalbuminemia and shorter AoRD are independent risk factors for IDH among MHD patients.LVMI can predict the outcome of MHDpatients.Intradialytic hypotension is an independent risk factor for long-term mortality in MHD patients.

Objective To investigate the prevalence and dissemination mechanism of 16S rRNA methylase genes in extended-spectrum beta-lactamases(ESBLs)-producing Enterobacteriaceae in China.Methods PCR amplification and DNA sequencing were used for screening and identifing 16S rRNA methylase genes and ESBLs genes.Minimal inhibitory concentrations(MICs)of the antimicrobial agents were detected by Etest.Conjugation and plasmid extract were performed to study dissemination mechanism of 16S rRNA methylase genes and ESBLs genes.Results Only one strain.Klebsiella oxytoca strain ZJ157 was screened as positive for armA gene from 447 ESBLs-producing isolates,which also contained CTX-M-15 and TEM-1 genes.It was resistant to aminoglycesides,ciprofloxacin,and most β-lactams,except carbapenems,polymyxin E and tigecyeline.Resistance to amikacin and β-lactams was transferred to a recipient Escherichia coli 600 by conjugation experiment.arntA.CTX-M-15 and TEM-1 genes were detected in the transconjugant.A plasmid about 55 kb was extracted from Klebsiella oxytoca ZJl57 and the transconjugant.Conclusions A 16S rRNA methylase gene armA was detected in an isolate of Klebsiella oxytoca.armA,CTX-M-15 and TEM-1 genes can be co-transferred in the same plasmid leading to multi-drug resistance.

Objective To assess the risk factors of intradialytic-hypotension (IDH) among maintaining hemodialysis (MHD) patients and to explore the relation between NT-proBNP and IDH,thus to provide clinical evidence for the prevention and treatment of IDH.Methods A total of 202 MHD patients during March 2009 to May 2009 in our dialysis center were enrolled in the study.Intradialytic blood pressure (BP) was measured during a 3-month period.IDH was defined as an event characterized by a sudden drop in systolic BP more than 20 mm Hg or in mean artery pressure (MAP) more than l0 mm Hg.Logistic regression analysis was used to assess the risk factors of IDH.ROC curve was used to evaluate the diagnostic efficacy of serum NT-proBNP.Results The incidence of IDH was 42.1％.One hundred and seventeen patients with no-IDH (＜1/10 hypotensive events per 3 months) were served as controls.Fifty-five patients with o-IDH (≥ 1/ 10 but ≤1/3 hypotensive events per 3 months) and 30 patients with f-IDH (＞1/3 hypotensive events per 3 months) were identified among 202 patients.Multivariate regression analysis showed that age,gender,ultrafiltration rate,serum NT-proBNP,serum albumin,aortic root dimension (AoRD) were associated with IDH among MHD patients.Serum NT-proBNP was positively correlated with IDH.The area under the ROC curve (AUC) of NT-proBNP was 0.76 (95％ CI 0.69 to 0.83,P＜0.01).The cut-off value of serum NT-proBNP for IDH was 1746.5 ng/L,with a sensitivity of 88.61％ and a specificity of 51.10％.Furthermore,the AUC of NT-proBNP for f-IDH was 0.65 (95％ CI 0.53 to 0.763,P＜0.01).The cut-off value of serum NT-proBNP for f-IDH was 8208.0 ng/L,with a sensitivity of 33.33％ and a specificity of 91.30％.Conclusions Elderly,female,high ultrafiltration rate,high level of serum NT-proBNP,hypoalbuminemia,shorter AoRD are independent risk factors of IDH among MHD patients.Serum NT-proBNP can be used as a predictor of IDH.

Objective To study interdialytic body weight gain(IBWG)in maintenance hemodialysis(MHD)patients,and to analyze the associated factors. Methods A total of 269 patients undergoing maintenance hemodialysis were enrolled in this cross-sectional study.The patients were divided into two groups according to the percentage of IBWG(PIBWG:interdialytic body weight gain/dry weight×100%):PIBWG＞3.50%(190 cases)and PIBWG≤3.50%(79 cases).Associated factors of IBWG were analyzed. Results The average IBWG of 269 MHD patients was(2.42±1.01)kg(0-6.33 kg),and PIBWG was(4.25±1.79)%.In male patients,IBWG was (2.45±1.09)kg,and PIBWG was(3.99±1.79)%.In female patients,IBWG was(2.39±0.85)kg,and PIBWG was(4.64±1.74)%which was significantly higher compared to males(P＜0.01).Patients with PIBWG＜3.00%accounted for 20%,with PIBWG≥3.00%to＜5.00%accounted for 50%,with PIBWG≥5.00%accounted for 30%.Compared to patients with PIBWG＞3.50%,those with PIBWG≤3.50%were characterized by elder age(year)(60.50 ±14.49 vs 54.07±13.78),more males(70.88%vs 54.74%),shorter dialysis duration(month)(41.03±41.92 vs 58.83±43.57),larger BMI(kg/m2)(22.67±3.36 vs 20.91±3.25)and less dry weight(kg)(56.69±10.94 vs 62.82±10.97),more residual urine(ml,In)(6.19±0.94 vs 5.48±0.8),lower predialysis serum β2MG(mmol/L)(31.61±9.82 vs 38.54±10.38)and phosphorus(mmol/L)(1.92±0.66 vs 2.15±0.58).Correlation analysis revealed that PIBWG was positively correlated with dialysis duration,Scr,BUN,β2-MG,phosphorus,decrease and decrease percentage of BP during hemodialysis,and negatively correlated with age,dry weight,BMI,residual urine,and pre-dialysis SBP,MAP. Conclusions PIBWG of about 70%of our patients was below 5%.Young.female.low BMI and dry body weight,long dialysis duration,low residual urine,chronic glomerulonephritis and diabetic nephropathy are associated with more IBWG,which may lead to greater intradialytic BP fluctuation.

Objective To explore the potential risk factors for aortic and mitral valve calcification in maintenance hemodialysis(MHD)patients. Methods Patients on MHD for at least 6 months.aged≥1 8 years without history of surgery or catheter for heart valve disease were enrolled in the study.Echocardiographic examination was performed to detect the calcification.The risk factors for aortic and mitral valve calcification were analyzed by Logistic regression. Results One hundred and eighty-one MHD patients(98 men and 83 women)were enrolled in the study.Of all the patients,aortic or mitral valve calcification was found in 94 patients(5 1.9%),aortic valve calcification in 90 patients(49.7%),mitral valve calcification in 30 patients(16.6%),aortic and valve calcification in 26 patients(14.4%).Multivariate Logistic regression showed that age(β=5.52,P=0.007),dialysis duration(β=6.99,P=0.039)and pre-albumin(β=-12.616,P=0.004)were independently correlated with aortic valve calcification.Mitral valve calcification was independently correlated with dialysis duration(β=6.057,P=0.002),history of primary hypertension(β=3.054,P=0.008),hemoglobin(β=-0.061,P=0.035)and β2 microglobulin(β=7.63,P=0.01).While the correlation between mitral valve calcification and age was borderline significant(β=0.085,P=0.05).Conclusions Valve calcification is prevalent in MHD patients,and aortic valve calcification is more common than mitral valve calcification.Age,dialysis duration and low serum pre-albumin are independent risk factors for aortic valve calcification.The risk factors for mitral valve calcification include age,dialysis duration,history of primary hypertension,anemia and high serum β2 microglobulin.

Objective To identify the efficacy and safety of aspirin in reducing the serum high sensitivity C reactive protein(hsCRP)level and preventing the internal arteriovenous fistulas(AVF)embolism in maintenance hemodialysis patients. Methods One hundred and ten hemodialysis patients using AVF more than 3 months were randomly divided into 2 groups,the intervention group(n=55,received aspirin 100 mg/d)and the control group(n=55).Examinations were performed at baseline and 6-month after treatment.Serum hsCRP level,platelet aggregates ratio(PAR),coagulation and inflammation indicators were measured.AVF embolism and the adverse events were monitored. Results Six months later.PAR and hsCRP level of the intervention group patients aged≤60 years decreased significantly [(68.14±8.45)%vs (82.37±9.12)%;(4.79±4.81)mg/L vs(6.94±10.26)mg/L,all P＜0.05],and were significantly lower as compared to.the control group[(68.14±8.45)%vs(74.7±11.50)%,(4.79±4.81)mg/L vs(5.12±9.25)mg/L,all P＜0.05].There were 2 cases of AVF embolism occured in both groups,which showed no statistical difierence (P=0.676).The incidence of adverse effeets was higher in the intervention group than that in the control group but no statistical significance was found (20.0%vs 7.2%,P=0.052),while the mortality rate had no difference between 2 groups (3.6%vs 0,P=0.495).Conclusion Use of aspirin 100 mg/d for 6 months can significantly reduce the serum hsCRP level and PAR in hemodialysis patients under 60-year-old without serious adverse reactions.

Objective To study the urea rebound after hemodialysis in maintenance hemodialysis (MHD) patients and its impact factors. Methods From 124 stable MHD patients, blood samples were collected at the beginning, immediate post-hemodialysis, 15 minutes and 30 minutes after hemodialysis. The urea rebound was quantified, and its effect on URR and spKt/V was investigated. The impact factors on urea rebound were analyzed. Results In this group of patients, average post-hemodialytic urea rebound was 13.6%, leading to over-estimation of URR and spKt/V of 0.04 and 0.14, respectively. Hemodialysis efficiency expressed as K/V determined urea rebound most significantly. Other impact factors included higher hemoglobin, higher relative ultrafiltration, arteriovenous access, and male patients. Conclusions Urea rebound is common after the hemodialysis. For specific patients and hemodialysis sessions, ignoring it would result in significant over-estimation of delivered hemodialysis dose.