Objective To investigate the levels and influencing factors for eye lens dose of interventional radiology workers, and to provide a basis for reasonable and scientific radiation protection. Methods Thermoluminescent eye lens dosimeters were used to monitor the left and right eye lens doses of interventional radiology workers in real time during different surgical positions and varying eye protection conditions. The annual eye lens doses for the operators were estimated based on their yearly workload. The differences in eye lens doses under different conditions were analyzed and the influencing factors were identified. Results For individual interventional operations, the range of personal dose equivalent H_p(3) of the left eye of interventional radiology workers was ( < MDL ~ 418.33) μSv, the median (Q₁, Q₃) was 9.29 ( < MDL, 40.79) μSv, and the mean was 40.79 ± 70.36 μSv. The estimated annual eye lens doses were 4.05 mSv and 17.80 mSv based on the median and mean values of the eye lens dose of a single operation multiplied by average annual frequency of operations per person, respectively. The left eye lens dose was higher than the right eye lens dose of the same operator (Z = −4.24, P < 0.05), and the dose of the right eye lens was strongly positively correlated with that of the left eye lens. The left eye lens dose of the first surgeon was higher than that of the second surgeon in the same operation (Z = −3.10, P < 0.05). The eye lens dose was influenced by operator position (χ² = 9.149, P = 0.002, OR = 8.343), eye protection (χ² = 4.619, P = 0.032, OR = 4.352), and air kerma area product (χ² = 8.032, P = 0.005, OR = 5.488). Conclusion According to the results of this study, a significant portion of interventional operators have eye lens doses that approach or exceed international occupational dose limits. It is recommended to pay attention to the operation frequency of the first operator and the air kerma area product of interventional operation, and strengthen radiation protection and dose monitoring for the eye lens of interventional radiology workers.

Objective:To explore the status quo and influencing factors of death anxiety among middle-aged and young adult patients with chronic heart failure (CHF) .Methods:Totally 176 middle-aged and young adult CHF patients treated at Fuwai Central China Cardiovascular Hospital between January 2021 and February 2023 were selected by convenience sampling and investigated with a general information questionnaire, the Medical Coping Modes Questionnaire (MCMQ), and the Death Anxiety Scale.Results:A total of 176 questionnaires were distributed, with 170 valid responses, yielding an effective response rate of 96.59%. Among the 170 middle-aged and young adult CHF patients, 136 had low death anxiety, while 34 had high death anxiety. Multiple linear regression analysis showed that educational level, per capita monthly family income, duration of illness, cardiac function classification, physical exercise, and coping style (yielding) were influencing factors of death anxiety in middle-aged and young adult CHF patients ( P<0.05) . Conclusions:Death anxiety in middle-aged and young adult CHF patients is primarily associated with educational level, per capita monthly family income, duration of illness, cardiac function classification, physical exercise, and coping style (yielding). Clinical assessments should focus on these factors to provide timely and targeted psychological interventions.

Objective:To analyze the correlation of cyclin-dependent kinase 4 (CDK4) and breast cancer resistance protein (BCRP) expression with pathological features and prognosis of breast cancer.Methods:From Jan. 2020 to Jun. 2021, 132 breast cancer patients admitted to our hospital were chosen. The surgically removed breast cancer tissues and adjacent tissues of all patients were collected, and the expressions of CDK4 and BCRP were detected by immunohistochemical staining. Clinical data of all patients were collected, and the correlation among CDK4, BCRP expression and pathological features, prognosis was analyzed.Results:The positive expression rates of CDK4 and BCRP in breast cancer tissues were higher than those in adjacent tissues ( P <0.05) ; The positive expression rate of CDK4 and BCRP was associated with differentiation degree, TNM stage and lymph node metastasis (all P <0.05) ; Kaplan-Meier analysis showed that the cumulative survival rate of CDK4 and BCRP negative expression group was higher than that of positive expression group ( P <0.05) ; Differentiation degree, TNM stage, lymph node metastasis, CDK4 expression and BCRP expression were independent prognostic factors for overall survival of breast cancer patients (all P <0.05) . Conclusions:CDK4 and BCRP have high positive expression rates in breast cancer tissues, and their expression is related to pathological features, with certain value in evaluating the prognosis of breast cancer patients.

Objective:To investigate the pathogens and drug resistance of bacterial enteritis in children, analyze the clinical characteristics of bacterial enteritis in children, and provide basis for clinical diagnosis and treatment.Methods:The fecal culture strain and drug sensitivity of patients with bacterial enteritis admitted to our hospital from January 2016 to December 2020 were analyzed and summarized, and the clinical characteristics of patients who were infected by Salmonella and Escherichia coli were compared.Results:There were a total of 173 patients, aged from 21 days to 15 years, with a median age of 2.00(1.10, 3.54)years.Bacterial enteritis was most likely to occur in summer and autumn, and the incidence rate was 40.5% and 29.5%, respectively.One hundreds and seventy-three strains of bacteria were cultured in feces, including 148 strains of Salmonella(85.5%), 18 strains of Escherichia coli(10.4%), five strains of Staphylococcus aureus and two strains of Shigella.One hundreds and one of 141 patients who were infected with Salmonella were detected for leukocytes of in feces(71.6%), and four of 16 patients with Escherichia coli were detected for leukocytes(25.0%). The difference was significant( χ2=14.1, P<0.001). Eighty-eight of 113 patients(77.9%) who were infected by Salmonella with increased CRP(CRP>8 mg/L)and the proportion in Escherichia coli infection cases was 6/13(46.2%). There was significant difference( χ2=4.63, P=0.03). The drug sensitivity of Salmonella and Escherichia coli was summarized.There was no carbapenem resistant strain cultured; The sensitivity to piperacillin/tazobactam and cefoperazone/sulbactam was higher than 85%; The sensitivity to cefepime, ceftazidimeand ceftriaxone was higher than 75%; The sensitivity to ampicillin was lower than 30%, and the sensitivity to quinolones was between 20%-40%. Conclusion:Children aged 1-3 years are prone to bacterial enteritis in summer and autumn.The most common pathogens causing bacterial enteritis are Salmonella and Escherichia coli.White blood cells are more easily detected in feces of patients with Salmonella infection, and the increase rate of C-reactive protein in peripheral blood is higher.Patients with bacterial enteritis are recommended to use the third-generation cephalosporins and aforementioned antibiotics and piperacillin/tazobactam for empirical treatment.The sensitivity to quinolones is reduced, and may not be suitable for clinical application.

Objective:To explore the influence of selective fetoscopic laser occlusion of chorioangiopagous vessels (FLOC) versus Solomon surgery in the management of twin-to-twin transfusion syndrome (TTTS) on procedure-related complications, fetal survival rate, and residual anastomoses.Methods:A total of 59 pregnant women with TTTS who underwent FLOC in the Third Affiliated Hospital of Zhengzhou University from May 2018 to March 2020 were retrospectively enrolled and divided into Solomon ( n=33) and selective FLOC groups ( n=26) based on the FLOC operation method. Placentae of 25 pregnant women (15 in the Solomon group, 10 in the selective FLOC group) with both survival twins were perfused to observe the type and diameter of the residual anastomoses. Fetal survival rate, procedure-related complications, and the type and diameter of residual anastomoses were analyzed and compared between the two groups using two independent samples t-test, Mann-Whitney U test, χ2 test and Fisher's exact test. Results:(1) The operating time of Solomon was shorter than that of selective FLOC [74 min (60-90 min) vs 95 min (81-123 min), Z=2.906, P=0.004]. But no statistically significant differences in the gestational week at operation, time of pregnancy end, and the interval between operation and pregnancy end was observed between the two groups (all P>0.05). (2) There was no statistically significant difference in the survival rate of both twins, one fetus, at least one fetus, and the incidence of postoperative twin anemia-polycythemia sequence (TAPS) and recurrent TTTS in the Solomon group and selective FLOC group [64%(21/33) vs 50%(13/26), χ2=1.107; 15%(5/33) vs 35%(9/26), χ2=3.044; 79%(26/33) vs 85%(22/26), χ2=0.326; 3%(1/33) vs 12%(3/26), χ2=1.368; 0% (0/33) vs 4%(1/26), χ2=1.118; all P>0.05]. (3) There was no statistically significant difference in the number of placentae with residual anastomoses or the number of artery-to-vein, vein-to-artery, artery-to-artery, and vein-to-vein anastomoses between the two groups (7/15 vs 6/10, 2/8 vs 4/15, 3/8 vs 4/15, 2/8 vs 5/15, 1/8 vs 2/15; Fisher's exact test, all P>0.05), but the diameter of the residual anastomoses in the Solomon group was smaller than that in the selective FLOC group [(0.8±0.3) and (2.2±0.7) mm, t=0.764, P=0.034]. (4) Among the four pregnant women developed TAPS after operation, one patient had two residual artery-to-vein anastomoses in the placenta with diameter of 0.54 mm and 0.43 mm, respectively; one patient had one artery-to-vein anastomosis with a diameter of 0.64 mm; one had one artery-to-artery and one vein-to-vein anastomosis with diameter of 1.56 mm and 1.89 mm, respectively. Conclusions:Compared with selective FLOC, Solomon surgery can reduce the vessel diameter of residual anastomoses in women with TTTS, but does not reduce postoperative complications, nor improve the pregnancy outcomes.

Objective:To develop the certified reference material of cadmium in human urine (freeze-dried) .Methods:Urine were collected from normal human, and then the urine samples were prepared by adding standard, mixing, packing and freeze-drying. After homogeneity test and stability test, the urine samples were determined by two methods in seven independent laboratories, the uncertainty of the certified reference material was evaluated.Results:Take at least 0.20 ml solution of the certified reference material per use, and the homogeneity is good. The freeze-dried materials can be kept stable for 12 months at ≤4 °C, and the re-dissolved reference materials can be stabilized for 7 days at 4 °C. The standard values and uncertainty of the two levels were (5.34±0.34) μg/L and (15.47±0.72) μg/L, respectively.Conclusion:The standards met the requirements of national standards, and can be used to verify the methods of detecting cadmium in human urine and to detect the samples.

Objective:To develop the certified reference material of cadmium in human urine (freeze-dried) .Methods:Urine were collected from normal human, and then the urine samples were prepared by adding standard, mixing, packing and freeze-drying. After homogeneity test and stability test, the urine samples were determined by two methods in seven independent laboratories, the uncertainty of the certified reference material was evaluated.Results:Take at least 0.20 ml solution of the certified reference material per use, and the homogeneity is good. The freeze-dried materials can be kept stable for 12 months at ≤4 °C, and the re-dissolved reference materials can be stabilized for 7 days at 4 °C. The standard values and uncertainty of the two levels were (5.34±0.34) μg/L and (15.47±0.72) μg/L, respectively.Conclusion:The standards met the requirements of national standards, and can be used to verify the methods of detecting cadmium in human urine and to detect the samples.

Objective:To analyze the clinical characteristics of patients with different types of coronavirus disease 2019 (COVID-19).Methods:A total of 272 eligible COVID-19 patients who were admitted to Guangzhou Eighth People′s Hospital, Guangzhou Medical University from January 22 to February 15, 2020 were retrospectively enrolled. General characteristics, the first laboratory examination and imaging data of these patients were collected. According to the clinical classification, there were 236 cases in non-severe group (mild+ common type) and 36 cases in severe group (severe+ critical type). Comparisons between groups were performed by t test, chi-square test or rank-sum test when appropriate. Results:There were 23 males and 13 females in the severe group, 103 males and 133 females in the non-severe group, and the difference was statistically significant ( χ2=5.149, P=0.023). The age of severe group was (60.5±11.2) years, which was higher than that of non-severe group (46.8±15.7) years. The difference was statistically significant ( t=6.43, P<0.01). The lymphocyte (LYM) count, platelet (PLT) count and arterial partial pressure of oxygen (PaO 2) in the severe group were 0.90(0.55, 1.10)×10 9/L, 170.00(143.50, 198.00)×10 9/L and 73.50(69.70, 83.00) mmHg(1 mmHg=0.133 kPa), respectively, which were all lower than those in the non-severe group (1.42(1.09, 1.95)×10 9/L, 187.00(148.00, 230.00)×10 9/L and 96.00(83.20, 108.00) mmHg, respectively). The differences were all statistically significant ( Z=5.59, 2.00 and 5.00, respectively, all P<0.05). The levels of creatine kinase (CK), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), C reaction protein (CRP) and procalcitonin (PCT) in the severe group were 123.00(79.00, 212.00) U/L, 32.10(27.00, 47.40) U/L, 305.50(216.00, 396.00) U/L, 37.02(23.92, 63.66) mg/L and 0.09(0.05, 0.19) μg/L, respectively, which were all higher than those in the non-severe group (68.00(48.00, 103.00) U/L, 20.10(16.70, 26.20) U/L, 179.00(150.00, 222.00) U/L, 26.55(18.11, 36.96) mg/L and 0.04(0.03, 0.06) μg/L respectively), and the differences were all statistically significant ( Z=3.89, 5.60, 5.12, 2.85 and 5.43, respectively, all P<0.01). No significant differences were observed in white blood cell count, creatine kinase isoenzyme and blood lactate between the two groups ( Z=1.53, 0.41 and 1.00, respectively, all P>0.05). Conclusion:Gender, age, LYM count, PLT count, PaO 2, CK, AST, LDH, CRP and PCT could be used to provide reference for clinical classification of COVID-19 patients.

Objective: To development of ethylene glycol samples in silicone tubes, and the samples were applied to inter-laboratory comparison, through it to evaluate the detection capacity of occupational health testing laboratories. Methods: Three content levels of ethylene glycol samples in silicone tubes were prepared, and the homogeneity and stability of samples were investigated, the results were statistically analyzed. A robust statistical four-point distance method was used to calculate the results submitted by each participant laboratory and the test capability of the laboratory was assessed by the z-score method. Results: The statistic of the homogeneity of ethylene glycol samples in silicone tubes were less than the critical value (P>0.05) , and the samples were stable at room temperature for one month. The satisfactory rate of comparison between 204 laboratories was 88.24%. Conclusion The homogeneity and stability of the ethylene glycol samples in the silicone tubes can meet the requirements of proficiency testing and can be used for laboratory comparison. Most of the laboratories that participated in the comparison had the ability to detect ethylene glycol.

Objective: To analyze the results obtained from the proficiency testing program for determination of bovine blood lead and urinary cadmium, so as to evaluate the proficiency of the laboratories, and improve the detection and quality control capability of occapational health laboratory. Methods: Prepared 3 levels of lead samples with bovine blood as base material, taking Technical Norm of Primary Reference Material as Operating standard, 60, 80, 180 μg/L were used as the standard concentration. All samples were made for 200 bottles. Normal urine were used to prepared 3 levels of cadmium samples with 5.0, 7.0, 10.0 μg/L as standard concentration, then 3 level of samples were made for 200 bottles respectively. Blood lead and urinary cadmium samples were sent to each laboratory in the form of sample pairs. One-way ANOVA was used to investigate the homogeneity. The results of each laboratory were statistically analyzed by robust statistical method, and the detection ability of the laboratory was evaluated by the Z ratio score method. By consulting the test reports and original records of each participating laboratory, the reasons for the unsatisfactory results were analyzed. Results: The statistical F of the uniformity of blood lead 1.42, 1.37 and 2.85, F<3.13, P were 0.294, 0.314 and 0.059, respectively in 31 labs. There is no statistical significance in the difference of blood lead (P>0.05). And urine cadmium was less than the critical value (P>0.05). In all, 31 laboratories participated in the test of blood lead, and 28 loboratories paticipated in urine cadmium verification. The statistical F of the uniformity of urinary cadmium 1.90, 1.35 and 1.19, F<3.13. The homogeneity of the samples were in accordance with the requirements of proficiency testing program. The satisfactory rate of the results for blood lead was 84% (26/31) , and the satisfactory rate of urinary cadmium was 93% (26/28) . In the test of blood lead, 21 of the 31 laboratories were controlled by the standard material method. Totally, 20 of them get an satisfactory level, the rate was 95%. Conclusion Most of the laboratory test results were satisfactory, which showed that the detection capability for blood lead and urine cadmium was good. The main causes of unsatisfactory results were detection methods, tools of quality control ortraceability standards.