Objective To analyze bedside radiation dose rates for interventional surgery operators in Guangdong Province, examine dose distribution patterns, and identify potential weaknesses in radiation protection, and to provide guidance for optimizing radiation monitoring and protection measures. Methods A total of 209 digital subtraction angiography devices measured in Guangdong Province between 2017 and 2024 were used as the research objects. The first and second operator positions were set at 30 cm and 90 cm horizontally from the X-ray tube focal point, respectively. Monitoring points were set up at 155, 125, 105, 80, and 20 cm above the ground. Results The median bedside radiation dose rate for interventional surgery operators in Guangdong Province was 83.0 (3.9, 1044.0) μSv/h, indicating instances of exceeding standard limits. The overall dose rates under the old and new standards were 29.8 (3.9-346.5) μSv/h and 114.0 (4.0-1044.0) μSv/h respectively. Results for both standards showed a higher dose rate at the second than the first operator position. The dose rates at the heights of 105 cm (abdomen), 125 cm (chest), and 155 cm (head) were higher in the second operator position than in the first operator position. Additionally, 71.5% and 56.8% of the highest dose rate points under the new and old standards, respectively, were concentrated at 105 cm (abdomen), 125 cm (chest) and 155 cm (head) in the second operator position. Conclusion The principle of protection optimization should be followed, auxiliary protective facilities should be placed correctly, and attention should be paid to the protection of the second surgery operator position, especially above the abdomen. The dose rate results under the new standard were lower than those under the old standard, suggesting that the measurement method may overestimate radiation exposure at the secondary operator position.

Objective To compare the effectiveness and safety of semaglutide with dulaglutide in patients diagnosed with type 2 diabetes.Methods A multicenter retrospective cohort study was conducted to include patients with type 2 diabetes who received semaglutide or dulaglutide treatment at three hospitals between April 2021 and July 2023 in the study.The patients were divided into the semaglutide group(SEMA group)and the dulaglutide group(DULA group)based on their treatment.Propensity score matching was used to pair the two groups in a 1:1 ratio,aligning them based on baseline characteristics such as gender,age,body mass index,blood glucose levels,duration of diabetes,and complications.Various parameters including fasting blood glucose,2-hour postprandial blood glucose,glycosylated hemoglobin(HbA1c),serum creatinine,urea nitrogen levels,estimated glomerular filtration rate(eGFR),urinary albumin/creatinine ratio(UACR),and occurrences of adverse reactions were assessed at 3,6,9,and 12 months after the treatment.Results After propensity score matching,98 patients were included in both the SEMA and DULA groups,showing no statistically significant differences in baseline characteristics between the groups(P＞0.05).At each follow-up point,the fasting blood glucose,2-hour postprandial blood glucose,and HbA1c levels of both groups showed a significant decrease compared to the baseline(P≤0.05).The inter-group comparison revealed no statistically significant differences in the changes in fasting blood glucose,2-hour postprandial blood glucose,and HbA1c levels between the two groups(P＞0.05).At the 6th month,the SEMA group exhibited a statistically significant higher rate of HbA1c＜7％compared to the DULA group(P＜0.05).In the SEMA group,serum creatinine and urea nitrogen decreased significantly at the 6th month compared to baseline,while eGFR showed an increase at the 3rd and 6th month,and UACR decreased,all with statistical significance(P＜0.05).In the DULA group,there was a statistically significant increase in serum creatinine and decrease at the 3rd and 6th months in eGFR,respectively.Additionally,urea nitrogen levels decreased significantly at the 9th month,all differences were statistically significant(P＜0.05).The inter-group comparison revealed that at the 3rd and 6th month,the SEMA group exhibited a greater reduction in serum creatinine levels compared to the DULA group.Additionally,the SEMA group demonstrated a more pronounced increase in eGFR levels than the DULA group,with statistical significance(P＜0.05).At the 6th month,the SEMA group exhibited a significantly greater decrease in UACR and a significantly lower incidence of renal insufficiency compared to the DULA group(P＜0.05).There were no significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion Semaglutide and dulaglutide can significantly improve blood glucose control,exhibit comparable effectiveness and safety in lowering blood glucose levels,and semaglutide has a potentially protective effect on renal function.

In order to meet the accuracy requirements of hospitals for abnormal detection of fetal monitor data,a hospital fetal monitor data anomaly detection method based on Euclidean distance was proposed.In this method,according to the abnormal detection method of fetal monitor data in hospitals,the ultrasound Doppler detector was used to collect fetal heart rate signal data,and the fetal heart rate signal denoising method based on adaptive filtering was used to remove the noise components of the collected fetal heart rate signal.The denoised fetal heart rate signal was used as the identification sample of the abnormal fetal heart rate signal identification method based on Euclidean distance method.The Euclidean distance Euclidean distance between the denoised fetal heart rate signal and the normal fetal heart rate signal was analyzed by combining the Euclidean distance method and the strong classifier to analyze whether the virtual sinusoidal distance between the denoised fetal heart rate signal and the normal fetal heart rate signal was greater than the tuned Euclidean distance threshold.Fetal heart rate signal samples greater than the threshold were classified and diagnosed as abnormal monitoring data.The fetal heart rate information collected by the fetal monitor in the hospital was accurate,and the abnormal detection results were valid and reliable.

Objective:To analyze the awareness status and influencing factors of hepatitis C among patients presented to hospitals in Shandong province, to provide reference for the prevention and control of viral hepatitis C.Methods:A total of 22, 139 questionnaires were collected from local residents aged 15-65 who visited general hospitals in 16 cities in Shandong province from May to December 2021. The survey was conducted in the form of face-to-face questionnaires, including general demographic information and questions and answers on hepatitis C prevention, treatment. and related behavioral characteristics. There are a total of 8 questions on the prevention and treatment of hepatitis C, and if 6 questions are correct, it is judged as knowing.Results:The overall awareness rate of hepatitis C-related knowledge among those who visited hospitals in Shandong province was 57.75%. The awareness rate of hepatitis C knowledge among respondents aged less than or equal to 20, 21-40, and 41-59 was higher than that of the age group over 60 years old. The OR values were 1.49, 2.30 and 1.88, respectively; the awareness rate of respondents with education level of high school or junior college and above was higher than that of people with education level of junior high school and below, the OR values were 1.14 and 1.21, respectively; The awareness rate of physical examination population and invasive diagnosis and treatment population was higher than that of family planning clinic visits, with OR values of 1.20 and 1.28, respectively. The awareness rate of respondents with a history of visiting a doctor in an informal medical service was lower than that of the population without such behavior. Conclusions:The awareness rate of hepatitis C knowledge among hospital patients in Shandong province needs to be further improved. Carrying out different forms of publicity and education for different groups of people is an effective means and method to reduce the hepatitis C infection rate.

Objective:To compare the characteristics of MSM with different types of primary sexual partners and to analyze the factors associated with MSM not being tested for HIV in the last six months.Methods:MSM were recruited in nine cities of Shandong Province from April to July 2021, and face-to-face questionnaires were conducted to collect information on sociodemographic characteristics, high-risk behaviors, and HIV testing of MSM. Blood samples were taken for serological tests of HIV and syphilis antibodies.Results:A total of 3 008 men who had anal sex with men in the last six months were divided into three groups according to the type of primary sexual partner in the last six months: the fixed sexual partner group (36.83%, 1 108/3 008), the commercial sexual partner group (3.06%, 92/3 008), and casual sexual partner group (60.11%, 1 808/3 008). There were statistically significant differences in the distribution of age, local residence time, education level, the primary place to find male sexual partners, use of new-type drugs in the last six months, consistent condom use every time during same-sex anal sex in the last six months, group sex in the last six months, no HIV testing in the last six months, having had a sexually transmitted disease in the last year, receiving peer education in the last year, and frequency of syphilis testing in the last year among different groups ( P<0.05). Multivariable logistic regression analysis showed that related factors of not being tested for HIV in the last six months in MSM were those aged less than 30 years old (a OR=1.39, 95% CI: 1.06-1.83), married/cohabiting (a OR=1.74, 95% CI: 1.39-2.16), high school education or less (a OR=1.39, 95% CI: 1.15-1.67), had not used new-type drugs in the last six months (a OR=2.27, 95% CI: 1.89-2.71), had not received peer education in the last year (a OR=1.59, 95% CI: 1.28-1.98), had never been tested for syphilis (a OR=11.30, 95% CI: 8.15-15.66), had not been tested in the last year but had been previously tested for syphilis (a OR=5.65, 95% CI: 4.19-7.62), the type of primary sexual partner in the last six months being a commercial sexual partner (a OR=1.80, 95% CI: 1.01-3.20), and the type of primary sexual partner in the last six months being a casual sexual partner (a OR=1.50, 95% CI: 1.26-1.80). Conclusions:The characteristics of MSM with different types of primary sexual partners are different, and the proportion of HIV testing still needs to be improved. In the future, we should make full use of the Internet and peer education to expand the coverage of HIV testing for MSM, targeting the characteristics of MSM with different types of primary sexual partners.

Objective:To explore the influencing factors of AIDS-related deaths among HIV-infected patients in Shandong Province, to help reduce the risk of death and prolong survival time.Methods:The study population was HIV-infected patients in Shandong Province from 2017-2021, and Cox proportional hazards regression model was used to analyze the influencing factors of AIDS-related deaths and deaths within one year of confirmation.Results:Among 14 700 HIV- infected patients reported in Shandong Province in 2017-2021, 351 AIDS-related deaths occurred, accounting for 2.4% (351/14 700). The results of multifactorial Cox proportional hazards regression model analysis showed that the risk factors for AIDS-related deaths among HIV-infected patients included education level of junior high school, high school, and secondary school (a HR=1.37, 95% CI:1.01-1.84), sample source from healthcare institutions (a HR=1.61, 95% CI:1.22-2.12), duration of disease in AIDS stage (a HR=9.86,95% CI:6.86-14.19), baseline CD4 +T lymphocytes (CD4) undetected (a HR=3.93, 95% CI:2.69-5.75), duration of antiviral treatment (ART) <6 months (a HR=3.46, 95% CI:2.42-4.93) and no ART (a HR=1.45, 95% CI:1.02-2.07), final CD4 <200 cells/μl (a HR=3.51, 95% CI:2.18-5.65) and final CD4 undetected (a HR=10.58, 95% CI:6.15-18.19), and final viral load (VL) values of 50-999 copies/ml,≥1 000 copies/ml and undetected (a HR=2.59, 95% CI:1.07-6.26; a HR=9.50, 95% CI:5.60-16.12; a HR=15.33, 95% CI:8.91-26.36). Factors with higher risk of AIDS-related deaths within one year of confirmation of HIV-infected patients included samples originating from healthcare facilities (a HR=1.68, 95% CI: 1.19-2.36), AIDS stage of disease (a HR=10.60, 95% CI:7.13-15.75), baseline CD4 undetected (a HR=3.71, 95% CI:2.34-5.90), duration of ART <6 months (a HR=4.30, 95% CI:2.85-6.49) and no ART (a HR=2.05, 95% CI:1.35-3.13), final CD4 <200 cells/μl (a HR=5.45,95% CI:2.04-14.60) and final CD4 undetected (a HR=20.95, 95% CI: 7.69- 57.04), and final VL values of 50-999 copies/ml, ≥1 000 copies/ml and undetected (a HR=15.21, 95% CI: 2.54-91.21; a HR=42.93, 95% CI:9.64-191.20; a HR=61.35, 95% CI:13.85-271.77). Conclusions:Expanding the coverage of testing, promoting early detection and treatment, strengthening regular follow-up and the test of HIV-infected patients, grasping the progress of the disease to provide accurate management and treatment are important for reducing the disease mortality rate and prolonging the survival time of HIV-infected patients.

Objective:To analyze the status of first viral load (VL) suppression for newly diagnosed HIV/AIDS on antiretroviral therapy (ART) from 2014 to 2016 in Shandong province, to provide theoretical evidence for improvement of ART effectiveness.Methods:Based on a retrospective cohort study, logistic regression model was used to identify influencing factors about VL suppression.Results:There were 4 833 newly diagnosed HIV/AIDS cases who received ART from 2014 to 2016 in Shandong province, and 3 449 cases achieved VL suppression at the first VL testing. The rate of first VL suppression was 71.36%. The possibilities of first VL suppression among patients on ART with education at junior high school, junior college and above were higher than those with education at primary school and below, with OR values at 1.75 and 2.00, separately. The possibilities of first VL suppression for patients treated at medical institutions was higher than those by CDC, with OR value 1.29. The possibilities of first VL suppression among patients whose CD4 count level at 201-350, 351-500 and ≥501 cells/μl were higher than that of the patients whose CD4 count level at ≤200 cells/μl, with OR values at 2.36, 2.11 and 2.66, respectively. The possibilities of first VL suppression among patients who missed doses was lower than those who did not miss doses, with OR value at 0.55. All the Pvalues for the above comparisons was <0.05. Conclusions:The suppression of viral load for HIV/AIDS on ART was influenced by culture level, CD4 count level at the entry of ART, treatment institutions and adherence to the therapy. Earlier diagnosis, treatment services provided by medical institutions and improvement of drug adherence can enhance ART effectiveness.

Objective: To analyze the epidemiological characteristics of HIV/AIDS infected students in Shandong Province, to provide a basis for the prevention and control of AIDS transmission in the student population. Methods: All 863 HIV/AIDS students cases during 2010-2019 were collected in Shandong Province. Epidemiological characteristics was described and the trends in the 10 years since 2010 was analyzed. Results: These 863 HIV/AIDS students were mainly transmitted through homosexual sex (763 cases, 88.41%), and the samples were mainly from voluntary consultation testing (433 cases, 50.17%). From 2010 to 2019, the proportion of student cases in the total number of cases showed an increasing trend ( χ 2 trend =30.21, P <0.01). Among them, the proportion of homosexual transmission cases increased year by year ( χ 2 trend =6.35, P =0.01), the proportion of cases aged 18-22 years increased year by year ( χ 2 trend =6.10, P =0.01), the proportion of cases with college degree or above increased year by year ( χ 2 trend =4.26, P =0.04). At present, voluntary consultation testing were the main source.There was no significant difference between the years of sample sources ( χ 2 trend =2.97, P =0.09). Conclusion The report number of students in Shandong Province are on the rise in recent years, especially those infected by same sex transmission, mainly with high education background, which calls for targeted strategies and intervention measures.

Objective:To analyze the timeliness and influencing factors of antiretroviral treatment (ART) among HIV/AIDS patients from 2017 to 2019 in Shandong province.Methods:Data were collected from the Chinese HIV/AIDS Comprehensive Response Information Management System, HIV/AIDS cases enrolled in antiretroviral therapy, from January 1, 2017 to December 31, 2019, ≥15 years of age and from the mainland of China were the subjects of the study. The general demographic characteristics (gender, age, ethnicity, education level, marital status, etc), infection routes, sample sources, date of diagnosis, baseline CD4+ T cell level, and clinical stage and other information were collected from the database. Univariate analysis was conducted for the timeliness of ART of the subjects by Chi square test, and the influencing factors associated with timeliness of ART were analyzed by binary non-conditional Logistic regression.Results:Among the 7 425 cases of HIV/AIDS, 6 813(91.8%) were male, 5 236(70.5%) had homosexual transmission, the age at the ART initiation was(36.05±12.51)years. The proportion of timeliness of ART within 30 d increased from 55.9% (1145/2050) in 2017 to 65.3% (1821/2789) in 2019. The possibility of timeliness of ART among HIV/AIDS who were married or cohabiting, education of high school and above were higher, with OR values at 1.136, 1.299. The possibility of timeliness of ART among HIV/AIDS cases whose domicile place is outside Shandong province were lower, with OR values at 0.664. The possibility of timeliness of ART in group of HIV/AIDS aging≥55, 45~54 and 35~44 years old were higher than that in 15~24 years old, with OR values at 1.530, 1.505 and 1.394. The possibility of timeliness of ART among the heterosexuals were lower than that of homosexuals, with OR values at 0.803. The possibility of timeliness of ART is lower for cases in places of detention centers than cases from volunteer testing and counseling, with OR values at 0.204. The possibility of timeliness of ART among HIV/AIDS cases whose CD4+ T lymphocyte at >500 cells/μL were lower than that of the cases whose CD4+ T lymphocyte at≤500 cells/μl, with OR values at 0.545. Patients without symptoms at baseline were less likely to receive prompt treatment than those with clinical symptoms, with OR values at 0.727. Patients with baseline clinical staging of stage Ⅳ, period of HIV/AIDS treatment with timeliness was longer than the cases with baseline clinical stages ofⅠ, Ⅱ, Ⅲ, with OR values at 1.307. Conclusions:The proportion of timeliness of ART increased from 2017 to 2019. Marital status, educational level, age, sample source, infection routes, baseline clinical stage, and CD4+ T lymphocyte levels were associated with the timeliness of ART.

Objective:To understand the use of drug and its related factors among men who have sex with men, and to provide reference for the development of reasonable intervention measures.Methods:MSM was recruited from Jinan and Qingdao by means of on-site and internet recruiting from March to June in 2016. Anonymous questionnaires were conducted and HIV and syphilis serological tests were performed. The questionnaire included the general situation, sexual behavior, HIV related services and so on. Multi-factor unconditioned logistic regression model was used to explore related factors about rush poppers use.Results:The rush poppers use rate of 901 MSM was 30.1%（271/901）, the age was (29.3±8.1) years, the HIV infection rate was 4.6% (41/901) and the syphilis infection rate was 8.7% (78/901). Multivariate analysis showed that compared with those who were>25 years old, the OR (95% CI) of those who were ≤ 25 years old was 1.571 (1.110-2.224); compared with the number of anal sexual behavior was<2 times in the last week, the OR (95% CI) of those whose number of anal sexual behavior was ≥2 times was 2.991 (1.100-8.132); compared with those who had not received peer education services in the last year, the OR (95% CI) of those who received peer education services was 13.651 (7.239-25.742). Conclusion:Rush poppers are very popular in the MSM crowd, and those who aged less than 25 years old, who had anal sex more than twice in the past week, and who had received peer education services were more likely to use rush poppers. We should carry out targeted interventions according to the characteristics.