Objective:To investigate the correlation between serum Vitamin D, uric acid levels and arterial calcification in maintenance hemodialysis patients.Methods:A total of 120 patients who received MHD treatment in Daxing Teaching Hospital, Capital Medical University, from March 2019 to March 2021 were retrospectively selected as research subjects, and their general clinical data were recorded in detail. X-ray was used to detect the arterial calcification of patients. Multivariate Logistic regression was used to analyze the risk factors of arterial calcification in MHD patients.Results:According to the arterial calcification score, 120 MHD patients were divided into non-calcification group (43 cases, 35.83%), mild calcification group (16 cases, 13.33%), moderate calcification group (42 cases, 35.00%) and severe calcification group (19 cases, 15.83%). There were significant differences in dialysis years, serum Vitamin D, serum uric acid, serum calcium, serum phosphorus, intact parathyroid hormone (iPTH) and arterial calcification score among the four groups ( P<0.05). According to serum Vitamin D level, 120 MHD patients were divided into deficient serum Vitamin D group (84 cases, 70.00%) and normal serum Vitamin D group (36 cases, 30.00%), serum calcium and phosphorus levels in the deficient serum Vitamin D group were lower than those in the normal serum Vitamin D group: (2.53 ± 0.28) mmol/L vs. (3.15 ± 0.31) mmol/L, (1.83 ± 0.26) mmol/L vs.(2.07 ± 0.31) mmol/L; serum uric acid and arterial calcification scores in the deficient serum Vitamin D group were higher than those in the normal serum Vitamin D group: (512.41 ± 65.21) μmol/L vs.(311.94 ± 72.56) μmol/L, (6.92 ± 2.34) scores vs. (2.18 ± 2.01) scores, there were statistical differences ( P<0.05). One hundred and twenty MHD patients were divided into hyperuricemia group (77 cases, 64.17%) and uric acid normal group (43 cases, 35.83%) according to the level of serum uric acid, the serum Vitamin D level in the hyperuricemia group was lower than that in uric acid the normal group: (12.28 ± 5.18) μg/L vs. (28.84 ± 4.69) μg/L; and iPTH level and arterial calcification scores were higher than those in the uric acid normal group: (372.45 ± 90.31) ng/L vs. (291.60 ± 98.52) ng/L, (6.22 ± 2.52) scores vs. (2.72 ± 2.63) scores, there were statistical differences ( P<0.05). The results of multivariate Logistic regression showed that serum Vitamin D and uric acid levels were risk factors for arterial calcification in MHD patients ( P<0.05). Conclusions:Serum Vitamin D and uric acid levels are correlated with arterial calcification in MHD patients, and are the risk factors leading to arterial calcification in patients.

Background Noise is the most common occupational hazard in the automobile manufacturing industry with the most workers exposed. Automobile manufacturing industry is a high-risk industry for noise-induced hearing loss. Objective To understand the epidemiological characteristics of noise-induced hearing loss among workers in automobile manufacturing industry and explore related influencing factors. Methods A questionnaire survey, individual noise recording, and pure tone audiometry were conducted among workers (n=656) exposed to noise from five automobile manufacturing enterprises. The data on age, sex, exposure duration, noise intensity, kurtosis, and hearing loss were obtained. The positive rates of high-frequency noise-induced hearing loss (HFNIHL) and speech-frequency noise-induced hearing loss (SFNIHL) were calculated, and each factor was compared between workers with and without HFNIHL. Chi-square test and analysis of trend were conducted among different groups of age, sex, exposure duration, A-weighted equivalent continuous sound pressure level normalized to a nominal 8-hour working day (L_Aeq,8h), and kurtosis. Logistic regression analysis was conducted to analyze the factors influencing the positive rates of HFNIHL and SFNIHL. Results The exposure rates of non-Gaussian noise was 73.6%. The positive rates of HFNIHL and SFNIHL were 32.6% (214 workers) and 6.7% (44 workers), respectively. The HFNIHL workers showed older age, higher proportion of male, longer exposure duration, higher noise intensity (L_{Aeq,8 h}), and increased kurtosis than those without HFNIHL (P<0.05). The positive rates of HFNIHL increased with the increase of age, exposure duration, L_{Aeq,8 h}, and kurtosis (\begin{document}$ {\chi ^2} $\end{document}_trend-age=49.25, P<0.001; \begin{document}$ {\chi ^2} $\end{document}_{trend-duration}=22.19, P<0.001; \begin{document}$ {\chi ^2} $\end{document}_trend-LAeq=6.91, P=0.009; \begin{document}$ {\chi ^2} $\end{document}_{trend-kurtosis}=8.56, P=0.003). The results of logistic regression showed that age (OR=2.13, 95%CI: 1.67-2.71, P<0.001), sex (OR=2.29, 95%CI: 1.44-3.62, P<0.001), exposure duration (OR=1.43, 95%CI: 1.11-1.85, P=0.006), L_Aeq,8h (OR=1.37, 95%CI: 1.08~1.76, P=0.011), and kurtosis (OR=1.37, 95%CI: 1.14-1.63, P=0.001) were factors associated with the risk of HFNIHL, while only age was associated with the risk of SFNIHL (OR=2.15, 95%CI: 1.33-3.33, P=0.001). Conclusion Workers exposed to noise in automobile manufacturing industry are at a high risk of hearing loss. Age, sex, exposure duration, L_{Aeq,8 h}, and kurtosis are key influencing factors of hearing loss.

Background Occupational noise-induced hearing loss (NIHL) is one of the most prevalent occupational diseases in the world. With the development of industry, noise sources in the workplace have become increasingly complex. Objective To apply kurtosis-adjusted cumulative noise exposure (CNE) to assess the occupational hearing loss among furniture manufacturing workers, and to provide a basis for revising noise measurement methods and occupational exposure limits in China. Methods A cross-sectional survey was conducted to select 694 manufacturing workers, including 542 furniture manufacturing workers exposed to non-Gaussian noise, and 152 textile manufacturing workers and paper manufacturing workers exposed to Gaussian noise. The job titles involving non-Gaussian noise were gunning and nailing, and woodworking, while those involving Gaussian noise were weaving, spinning, and pulping. High frequency noise-induced hearing loss (HFNIHL) and noise exposure data were collected for each study subject. Noise energy metrics included eight-hour equivalent continuous A-weighted sound pressure level (L_{Aeq,8 h}) and CNE. Kurtosis was a noise temporal structure metric. Kurtosis-adjusted CNE was a combined indicator of noise energy and temporal structure. Results The age of the study subjects was (35.64±10.35) years, the exposure duration was (6.71±6.44) years, and the proportion of males was 75.50%. The L_{Aeq,8 h} was (89.43±6.01) dB(A). About 81.42% of the study subjects were exposed to noise levels above 85 dB(A), the CNE was (95.85±7.32) dB(A)·year, with a kurtosis of 99.34 ± 139.19, and the prevalence rate of HFNIHL was 35.59%. The mean kurtosis of the non-Gaussian noise group was higher than that of the Gaussian noise group (125.33±147.17 vs. 5.86±1.94, t=−21.04, P<0.05). The results of binary logistic regression analysis showed that kurtosis was an influential factor of workers' HFNIHL after correcting for age, exposure duration, and L_{Aeq,8 h} (OR=1.49, P<0.05). The results of multiple linear regression analysis showed that the effects of age, exposure duration, L_{Aeq,8 h}, and kurtosis on noise-induced permanent threshold shift at frequencies of 3, 4, and 6 kHz of the poor hearing ear were statistically significant (all P<0.05). The results of chi-square trend analysis showed that when CNE ≥ 90 dB(A)·year, the HFNIHL prevalence rate elevated with increasing kurtosis (P<0.05). The mean HFNIHL prevalence rate was higher in the non-Gaussian noise group than in the Gaussian noise group (31.7% vs. 22.0%, P<0.05). After applying kurtosis-adjusted CNE, the linear equation between CNE and HFNIHL prevalence rate for the non-Gaussian noise group almost overlapped with that for the Gaussian noise group, and the mean difference in HFNIHL prevalence rate between the two groups decreased from 9.7% to 1.4% (P<0.05). Conclusion Noise kurtosis is an effective metric for NIHL evaluation. Kurtosis-adjusted CNE can effectively evaluate occupational hearing loss due to non-Gaussian noise exposure in furniture manufacturing workers, and is expected to be a new indicator of non-Gaussian noise measurement and assessment.

Objective:To evaluate the long-term health-related quality of life (QOL) in pediatric patients with acute leukemia after hematopoietic stem cell transplantation (HSCT) and to analyze potential influence factors.Methods:Patients with acute leukemia aging 8-18 years who received HSCT in the Hematology Oncology Center of Beijing Children′s Hospital from June 2009 to June 2012 with more than 80 months survival postoperatively were recruited.All of them were subjected to a short-term QOL survey in 2013.PedsQL? Transplantation Module 3.0 in Chinese mandarin version was completed.QOL data and influence factors were analyzed.Results:Forty-one patients completed the questionnaires, involving 32 males and 9 females with the mean age of(14.29±2.72) years.The mean scores of overall long-term QOL after HSCT were above 75 (total scores: 100), which was above the average.The age, disease status before transplantation, donor sources, post-transplant complications and the parental education level were the influential factors for the long-term QOL in pediatric patients with acute leukemia at post-HSCT, which could affect a certain dimension in QOL.Conclusions:The overall long-term QOL of pediatric patients with acute leukemia who survived for more than 80 months at post-HSCT is acceptable, which is significantly better than the short-term QOL after 4 months of HSCT.The age, disease status before transplantation, donor sources, post-transplant complications and the education level of parents could affect a certain dimension of QOL.

Objective:To investigate the influencing factors of post-dialysis hypertension in maintenance hemodialysis (MHD) patients.Methods:This study was a cross-sectional and retrospective study. The patients receiving hemodialysis from January 9, 2017 to January 14, 2017 in 5 hemodialysis centers of Beijing area were selected. Post-dialysis hypertension was defined as an event characterized by an average increase of more than 15 mmHg in post-dialysis mean artery pressure (MAP) compared to intradialytic 3 h MAP during 3 consecutive hemodialysis sessions. Post-dialysis stable blood pressure was defined as an event characterized by an increase of less than 15 mmHg or a decrease of less than 10 mmHg in post-dialysis MAP compared to intradialytic 3 h MAP, with the exception of patients with post-dialysis hypertension and post-dialysis hypotension. The patients were divided into hypertension group and stable blood pressure group based on whether they had post-dialysis hypertension, and the differences of clinical data between the two groups were compared. The influencing factors of post-dialysis hypertension were analyzed by multivariate unconditional logistic regression.Results:A total of 491 MHD patients were enrolled in this study, including 65 patients (13.2%) in the hypertension group, 406 patients (82.7%) in the stable blood pressure group and 20 patients (4.1%) in the hypotension group. The age, blood calcium before dialysis and the proportion of patients using 1.75 mmol/L Ca 2+ dialysate in the hypertension group were higher than those of the stable blood pressure group, and pre-dialysis serum intact parathyroid hormone and pre-dialysis serum uric acid in the post hypertension group were lower than those of the stable blood pressure group (all P<0.05). The age, pre-dialysis serum intact parathyroid hormone, pre-dialysis serum calcium, pre-dialysis serum uric acid, dialysate Ca 2+ concentration of statistical differences between hypertension group and stable blood pressure group ( P<0.05), and post-dialysis serum calcium, pre-dialysis total serum cholesterol, application of β receptor blocker, gender of univariate analysis ( P<0.1) were included into the logistic regression equation as covariates. Multivariate logistic regression analysis showed that using 1.75 mmol/L Ca 2+ dialysate was the independent influencing factor of post-dialysis hypertension (with using 1.50 mmol/L Ca 2+ dialysate as reference, OR=2.930, 95% CI 1.282-6.694, P=0.011). The age and pre-dialysis serum calcium of statistical differences between hypertension group and stable blood pressure group ( P<0.05), and pre-dialysis serum sodium and pre-dialysis serum uric acid of univariate analysis ( P<0.1) were included into the logistic regression equation as covariates. The older age ( OR=1.046, 95% CI 1.000-1.093, P=0.049) and higher pre-dialysis serum calcium ( OR=21.847, 95% CI 2.111-226.075, P=0.010) were the independent influencing factors of post-dialysis hypertension when the 1.50 mmol/L Ca 2+ dialysate was used. Conclusions:The independent influencing factor of post-dialysis hypertension is using 1.75 mmol/L Ca 2+ dialysate, while the independent influencing factors of post-dialysis hypertension are the older age and the higher pre-dialysis serum calcium level when the dialysate Ca 2+ concentration was 1.50 mmol/L.

Objective To investigate the drug resistance situation and Staphylococcal cassette chromosome mec(SCCmec) genotypes of methicillin resistant Staphylococcus aureus (M RSA ) strains isolated from Shang-hai Putuo District People′s Hospital in order to provide a theoretical basis for predicting the trend of drug re-sistant bacterial strains and clinical treatment and prevention of MRSA .Methods Three hundreds and eighty clinically isolated MRSA strains in this hospital were collected from January 2012 to December 2016 .The in vitro drug susceptibility test was performed by adopting the broth microdilution method .The SCCmec geno-types were examined by adopting the multiplex polymerase chain reaction .Results All strains were sensitive to linezolid and vancomycin ,the sensitivity rate was 100 .0％ ;the resistance rates to rifampicin and cotrimox-azole were lower ,which were 5 .0％ and 7 .6％ respectively ;but the strains were highly resistant to erythromy-cin ,levofloxacin and tetracycline ,with the resistance rate of 100 .0％ ,94 .2％ ,93 .4％ and 90 .0％ .The resist-ance rate to penicillin was 100 .0％ .Among 380 strains of MRSA ,there were 281 strains(73 .9％ ) of SCCmecⅡ ,59 strains (15 .5％ ) of SCCmecⅢand 5 strains (1 .3％ ) of SCCmecⅣa ,other 35 strains(9 .2％ ) of MRSA could not be classified .Conclusion M RSA strains isolated in the Shanghai Putuo District People′s Hospital are mainly the type SCCmecⅡ ,w hich has the multi-drug resistant characteristics ,and the drug resistance spec-trum of different SCCmec genotypes is different .

Objective To investigate current status of knowledge-attitude-behavior about unplanned extubation (UEX) of central venous catheter among infusion nurses in Guangdong Province.Methods The nurses who attended the 2015 intravenous therapy nursing training provided by Guangdong Nursing Association were selected as participants.A self-designed questionnaire about nurses' knowledge-attitude-behavior about UEX of central venous catheter was used to investigate 450 nurses.Results The proportion of nurses who reached good level in knowledge were 41.1％,nurses who had positive attitude were 71.0％,nurses who had positive behaviors were 30.0％.There were significant differences among nurses with different educational background,different titles and different hospital ranks(P＜0.05).Conclusion The knowledge-attitude-behavior of nurses are not satisfactory,especially those who are junior or have lower education or work in non-tertiary hospital.

Objective To investigate the presences of regulatory T cells (Treg) and natural killer T cell (NKT)-like T cells in the peripheral blood of healthy subjects and patients with newly diagnosed cancer. Methods Patients were enrolled into four groups: healthy subjects (Group A), patients without cancer (Group B), patients with newly diagnosed stage Ⅰ~Ⅱ cancer (Group C), and patients with newly diagnosed stage Ⅲ~Ⅳ cancer (Group D). Flow cytometry was performed to detect the percentage of CD4+ CD25high CD127low cells in CD4+ T lymphocytes (Treg) and the percentage of CD3+ CD56+ cells in CD3+ T lymphocytes (NKT-like). Results The percentage of Treg cells in CD4+T lymphocytes was(6.72 ± 3.16)%, (6.49 ± 2.83)%,(6.80 ± 3.07)%and (7.63 3.47)% in Group A, B, C and D, respectively, with no significant differences among these groups (P>0.05). However, the percentage of CD3+CD56+T cells in CD3+T lymphocytes was (3.13 ± 1.66)%, (2.56 ± 1.27)%,(7.22 ± 2.70)% and (7.72 ± 3.10)% in Group A, B, C and D, respectively, with marked increases in Group C and D compared to those in Group A and B (P < 0.05). Conclusion Patients with newly diagnosed cancer demonstrated increasing trends in the percentage of peripheral NKT-like cells.

Objective To investigate the imaging and pathological features of atypical teratoid/rhab doid tumor (AT/RT)occur-ring in the central nervous system (CNS).Methods The CT and MRI findings of 1 6 patients with CNS AT/RT were retrospectively analyzed,and their pathological and immunohistochemical results were studied.Results There were 12 males and 4 females. Tumors located is at supratentorial in 10 and infratentorial in 6.Cystic changes in tumors were noted in 12 cases.The solid portion of tumors was isointense on T2-weighted images relative to normal brain grey matter in 9 patients.Extensive peritumoral edema was observed in 1 1 lesions.The tumors showed bandlike rim of significant enhancement in 10 cases.The incidence of hemorrhage and calcification in tumors were 43.8% and 41.7% respectively.Histopathologically,AT/RT was characterized by the presence of rhab-doid cells associated with variable components of epithelial,primitive neuroectodermal and mesenchymal differentiation.Conclusion Atypical teratoid/rhabdoid tumor is several imaging findings which are relatively specific on CT and MR images.CT and MRI may provide valuable information for pre-operation diagnosis and prognostic evaluation in patients with CNS AT/RT.