1.Analysis of cystatin C combined with amino-terminal pro-brain natriuretic peptide to predict cardiovascular risk in maintenance hemodialysis patients
Zhihu TAO ; Qi XIAO ; Dongning LYU ; Renfa HUANG ; Wei SHI
Chinese Journal of Nephrology 2014;30(7):506-511
Objective To research the relationship between the serum level of cystatin C (CysC),N-terminal pro brain natriuretic peptide (NT-proBNP) and the cardiovascular (CV) events in maintenance hemodialysis (MHD) patients,looking for a new and effective biological prediction method for cardiovascular disease (CVD).Methods According to the excluded criteria and included criteria,a total of 126 patients [male 67(53.2%),female 59 (46.8%)] were included in this study,screening out of 452 MHD patients from 3 blood purification centre,no secondary hyperparathyroidism,blood pressure controlled,hemoglobin standard,no lipid abnormalities,and without history of coronary heart disease,heart failure and arrhythmia.Participants adopted 3 dialysis treatment,including hemodialysis,hemoperfusion and hemodiafiltration.Every 3 months before the dialysis,the Cys-C,NT-proBNP,serum phosphorus,serum intact parathyroid hormone (iPTH),hemoglobin and electrocardiogram were detected.The heartbeat ultrasound was examined every 6 months,observed for 24 months and followed up for 3 years,recording the incidence and the inspection results.The correlation and the occurrence of CVD were analyzed by conducting a multiple factor logistic regression analysis.The forecast performance of Cys-C,NT-proBNP was evaluated by using receiver operating characteristic (ROC) curves and area under curves (AUC).Results Eighteen episodes of CV events occurred in 126 patients during the experiment and follow-up,including 8 episodes of heart failure,4 episodes of myocardial infarction,6 episodes of arrhythmia.Detection indexes had no statistically significant correlation (P > 0.05),and the results of ECG and ultrasound heartbeat graph showed that no significant difference in cardiac structure and function before treatment (P > 0.05).After 24 months duration,the research showed that the level of serum calcemia was lower,and the levels of phosphorus and iPTH were higher in hemodialysis group compared with that in the other 2 groups,and the differences had statistical significance (P < 0.05).The median levels of Cys-C and NT-proBNP were 8.59 (9.74,7.10) mg/L and 7 739 (9 887,6 736) ng/L in the patients CV events occurred.Non conditional multivariate logistic regression analysis demonstrated that the increasing interdialytic weight,Cys-C,NT-proBNP,iPTH,dialysis hypotension were the independent risk factors of CV occurrence.AUCs to predict CVD occurrence in MHD patients was 0.64 (95%CI 0.53-0.71,P < 0.05) and 0.79 (95%CI 0.72-0.89,P< 0.01) using Cys-C and NT-proBNP respectively.The cut-off values of serum Cys-C and NT-proBNP for CVD occurrence were 8.59 mg/L and 7 739 ng/L,with a sensitivity of 84.3% and a specificity of 92.7%.Conclusions Cys-C,NT-proBNP can be used to predict the risk of CV events in dialysis patients.
2.Investigation on occupational hazards in a refrigeration equipment manufacturing enterprise
Shihuai ZHANG ; Zhihu ZHANG ; Ling TAO ; Bin FENG ; Hui WANG ; Haidong ZHANG ; Pu ZHANG
Chinese Journal of Industrial Hygiene and Occupational Diseases 2020;38(9):708-711
Objective:To investigate the distribution and intensity of noise and ultraviolet radiation of welding posts in a refrigeration equipment manufacturing enterprise, in conjunction with the health status of welding workers, providing scientific evidence for the prevention and control of occupational diseases in this type of post.Methods:In May 2019, a cross-sectional survey method was used to select 576 welding workers in the pressure vessel workshop and the unit assembly workshop of a refrigeration complete equipment manufacturer from 2016 to 2018 as the research objects. The occupational hygiene survey and occupational hazard factor measurement were carried out in the workplace, and the measurement data and occupational health examination results were statistically analyzed.Results:The over standard rate of individual Lex in pressure vessel workshop was 82.2% (37/45) . Compared with the unit assembly workshop, the individual Lex of welding workers in pressure vessel workshop was higher than that in unit assembly workshop ( t=13.43, P= 0.00) ; the effective irradiance exceeding rate of welding workers in pressure vessel workshop and unit assembly workshop was 33.3% (4/12) and 25.0% (3/12) , The meacurement of ovradiation in the moskment the occupational exposure limit. The deaf rate and hearing loss rate in pressure vessel workshop were 1.5% (5/336) 20.5% (69/336) , respectively, significantly higher than that in umit assembly workshop ( P<0.05) . The detection rate of hearing loss of pressure vessel workshop workers increased year by year, and the difference was statistically significant (χ 2trend=22.42, P<0.01) ; compared with the unit assembly workshop from 2016 to 2018, the detection rates of lens opacity, corneal cloudiness and hearing loss of pressure vessel workshop workers were statistically significant (χ 2=9.45, 14.80, 55.99, P<0.01) . Conclusion:Welding workers exposed to noise and ultraviolet radiation are easy to be ignored. The enterprise management department should attach great importance to it and take comprehensive measures to protect the health of welding workers.
3.Investigation on occupational hazards in a refrigeration equipment manufacturing enterprise
Shihuai ZHANG ; Zhihu ZHANG ; Ling TAO ; Bin FENG ; Hui WANG ; Haidong ZHANG ; Pu ZHANG
Chinese Journal of Industrial Hygiene and Occupational Diseases 2020;38(9):708-711
Objective:To investigate the distribution and intensity of noise and ultraviolet radiation of welding posts in a refrigeration equipment manufacturing enterprise, in conjunction with the health status of welding workers, providing scientific evidence for the prevention and control of occupational diseases in this type of post.Methods:In May 2019, a cross-sectional survey method was used to select 576 welding workers in the pressure vessel workshop and the unit assembly workshop of a refrigeration complete equipment manufacturer from 2016 to 2018 as the research objects. The occupational hygiene survey and occupational hazard factor measurement were carried out in the workplace, and the measurement data and occupational health examination results were statistically analyzed.Results:The over standard rate of individual Lex in pressure vessel workshop was 82.2% (37/45) . Compared with the unit assembly workshop, the individual Lex of welding workers in pressure vessel workshop was higher than that in unit assembly workshop ( t=13.43, P= 0.00) ; the effective irradiance exceeding rate of welding workers in pressure vessel workshop and unit assembly workshop was 33.3% (4/12) and 25.0% (3/12) , The meacurement of ovradiation in the moskment the occupational exposure limit. The deaf rate and hearing loss rate in pressure vessel workshop were 1.5% (5/336) 20.5% (69/336) , respectively, significantly higher than that in umit assembly workshop ( P<0.05) . The detection rate of hearing loss of pressure vessel workshop workers increased year by year, and the difference was statistically significant (χ 2trend=22.42, P<0.01) ; compared with the unit assembly workshop from 2016 to 2018, the detection rates of lens opacity, corneal cloudiness and hearing loss of pressure vessel workshop workers were statistically significant (χ 2=9.45, 14.80, 55.99, P<0.01) . Conclusion:Welding workers exposed to noise and ultraviolet radiation are easy to be ignored. The enterprise management department should attach great importance to it and take comprehensive measures to protect the health of welding workers.