Objective To use direct dilution method to pretreat human urine, and to determine 19 elements in human urine using inductively coupled plasma mass spectrometry, and to evaluate the uncertainty of the entire experimental process. Methods The relevant mathematical models were established according to JJF 10591-2012 ^“Evaluation and Expression of Measurement Uncertainty^” and CNAS-GL006 ^“Guidance for Evaluation of Uncertainty in Chemical Analysis^”. Taking molybdenum as an example, the uncertainty sources in the determination of 19 elements in human urine by inductively coupled plasma method were analyzed and evaluated, including sample pretreatment, sample repeated measurement, standard solution preparation and standard curve fitting. Results The extended uncertainty of molybdenum in human urine is 2.12μg/L, and the measurement result of molybdenum is (44.8±2.12)μg/L. The measurement result of 19 elements in human urine ranges from less than the detection limit to 601μg/L, and the extended uncertainty range is 0.38~33.6μg/L.Conclusion It was found from the calculation that the uncertainty of the determination result was mainly affected by the uncertainty of the sample repeated measurement and the standard curve fitting. By adjusting the range of standard curve and increasing the number of parallel sample measurement, the uncertainty was reduced and the quality of detection was improved.

Objective:To explore the relationship between lipid metabolism molecules in plasma and carotid atherosclerotic plaques,traditional cardiovascular risk factors and possible dietary related factors.Methods:Firstly,among 1 312 community people from those who participated in a 10-year follow-up study of subclinical atherosclerosis cohort in Shijingshan District,Beijing,85 individuals with 2 or more carotid soft plaques or mixed plaques and 89 healthy individuals without plaques were selected according to the inclusive and the exclusive criteria(＜70 years,not having clinical cardiovascular disease and other diseases,etc.).Secondly,10 cases and 10 controls were randomly selected in the above 85 and 89 individuals respectively.Carotid plaques were detected using GE Vivid i Ultrasound Machine with 8L de-tector.Lipid metabolism molecules were detected by high performance liquid chromatography-mass spec-trometry.The detection indexes included 113 lipid metabolism molecules.Traditional cardiovascular risk factors were collected by unified standard questionnaires,and dietary related factors were collected by main dietary frequency and weight scale.The difference of lipid metabolism molecules between the case group and the control group was analyzed by Wilcoxin rank test.In the control group,the Spearman cor-relation method was used to analyze the correlation between statistically significant lipid metabolism molecules and traditional cardiovascular risk factors and dietary factors.Results:Among the 113 lipid metabolism molecules,53 lipid metabolism molecules were detected.C24∶0 sphingomyelin(SM),C22∶0/C24∶0 ceramide molecules,C18∶0 phosphoethanolamine(PE)molecules,and C18∶0/C18∶2(Cis)phosphatidylcholine(PC)were significantly higher in the carotid atherosclerotic plaque group than in the control group.The correlation analysis showed that C24∶0 SM was significantly positively correlated with low density lipoprotein cholesterol(LDL-C,r=0.636,P＜0.05),C18∶2(Cis)PC(DLPC)was sig-nificantly positively correlated with systolic pressure(r=0.733,P＜0.05),C18∶0 PE was significantly positively correlated with high sensitivity C-response protein(r=0.782,P＜0.01),C22∶0,C24∶0 ce-ramide and C18∶0 PE were negatively correlated with vegetable intake(r=-0.679,P＜0.05;r=-0.711,P＜0.05;r=-0.808,P＜0.01),C24∶0 ceramide was also negatively correlated with beans food intake(r=-0.736,P＜0.05)in the control group.Conclusion:The increase of plasma C24∶0 SM,C22∶0,C24∶0 ceramide,C18∶0PE,C18∶2(Cis)PC(DLPC),C18∶0PC(DSPC)may be new risk factors for human atherosclerotic plaques.These molecules may be related to blood lipid,blood pres-sure or inflammatory level and the intake of vegetables and soy products,but the nature of the association needs to be verified in a larger sample population.

Objective:To investigate the role of subcutaneous negative pressure drainage device in the prevention of surgical site infections (SSI) of superficial incisional in lower digestive tract open surgeries.Methods:Clinical data of 104 patients receiving open surgeries on lower digestive tract at Beijing Friendship Hospital, Capital Medical University from October 2018 to June 2020 was analyzed by a propensity score matching (PSM), and the clinical data of 104 patients receiving open surgeries on lower digestive tract at Beijing Friendship Hospital, Capital Medical University from February to December 2021 was analyzed by a randomized controlled trial (RCT). Chi-square tests were conducted to analyze the association of subcutaneous negative pressure drainage device with SSI of superficial incisional. Univariate and multivariate Logistic regression analysis were used to identify the risk factors for SSI in superficial incisions.Results:Patients with subcutaneous negative pressure drainage device encounter significantly less SSI of superficial incisional in both the PSM study ( P=0.007) and the RCT study ( P=0.049). In the PSM study, the independent risk factors for SSI of superficial incisional via univariate and multivariate Logistic regression analysis were absence of subcutaneous drainage ( Puni=0.012, Pmulti=0.009) and postoperative anastomosis leak ( Puni=0.054, Pmulti=0.034). In the RCT study, the independent risk factors for SSI of superficial incisional via univariate and multivariate Logistic regression analysis were absence of subcutaneous drainage ( Puni=0.061, Pmulti=0.017), eldly ( Puni=0.076, Pmulti=0.032), long incision ( Puni=0.078, Pmulti=0.040). Conclusion:Subcutaneous negative pressure drainage device can significantly reduce SSI of superficial incisional in lower digestive tract open surgeries.

Objective To establish an evaluation method of uncertainty for the determination of lead in ambient air PM_2.5 by inductively coupled plasma mass spectrometry (ICP-MS). Methods According to HJ657-2013 ^“Determination of Lead and Other Metal Elements in Air and Exhaust Particulates by Inductively Coupled Plasma Mass Spectrometry^”, the concentration of lead in ambient air PM2.5 was determined. A mathematical model was established to analyze the source of uncertainty and to calculate each component of uncertainty. The components were combined into the standard uncertainty, and the relative expanded uncertainty was finally obtained. Results The expanded uncertainty of lead in ambient air PM2.5 was 0.16 ng/m³, and the measurement result of lead was (1.75±0.16)ng/m³. Conclusion The main source of uncertainty of this method comes from the relative standard uncertainty introduced by sample pretreatment.

BACKGROUND: Enterococcus faecalis strains with low-level resistance to linezolid (an oxazolidinone antibiotic) have become common. No large-scale study has examined the underlying mechanisms in linezolid-resistant E. faecalis (LRE) strains. We investigated these mechanisms and molecular characteristics in Chongqing, China. METHODS: A total of 1,120 non-duplicated E. faecalis strains collected from August 2014 to June 2017 underwent drug susceptibility testing. LRE strains were screened for optrA, cfr, and mutations in the 23S rRNA and ribosomal proteins L3 and L4 by PCR amplification and sequencing. Multi-locus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE) were used for epidemiological analysis. RESULTS: All 43 low-level LRE strains (minimum inhibitory concentration: 8–16 mg/L) harbored optrA; cfr and 23S rRNA mutations were not detected. Novel mutations in the ribosomal proteins L3 and L4—one deletion (Q103del) and four substitutions (S113L, T35A, I98V, and N79D)—were identified. Novel amino acid substitutions at positions E60K, G197D, and T285P of the OptrA protein were observed. MLST revealed 20 types of LRE strains; the most common type was ST16 (32.6%). PFGE showed 14 strains of ST16 with unique banding patterns. Eight novel sequence types (ST823 to ST830) and one allele (gki95) were identified for the first time in China. CONCLUSIONS: optrA plays an important role in linezolid resistance and may serve as a marker for resistance screening. Since the L3 and L4 mutations did not simultaneously occur in the same strain, they play a negligible role in linezolid resistance. Epidemiological investigation suggested that the LRE cases were sporadic.
Alleles ; Amino Acid Substitution ; China* ; Electrophoresis, Gel, Pulsed-Field ; Enterococcus faecalis* ; Enterococcus* ; Epidemiology ; Linezolid ; Mass Screening ; Molecular Epidemiology* ; Polymerase Chain Reaction ; Ribosomal Proteins

Objective? To explore the status and influencing factors of intern student nurses' personal career planning. Methods? A questionnaire survey was conducted among 258 intern student nurses in a ClassⅢ Grade A general hospital in Hu'nan province selected by convenience sampling from March to April 2018. Personal Career Planning Questionnaire for Nursing Students was used in the investigation. Results? The total score of 258 student nurses in personal career planning was (96.84±10.80). The overall satisfaction of the student nurses towards the nursing major and the status of class cadres were the influencing factors of the personal professional career planning (P＜0.01). Conclusions? The student nurses' personal career planning are at a medium level and influenced by various of factors. High nursing education should pay attention to the personal career planning of nursing students. Hospitals and departments should provide corresponding education, training and management for nursing students with different characteristics.

Objective To determine whether thyroid hormone (TH) level could also be an independent and incremental predictor of adverse events in patients with hypertrophic cardiomyopathy (HCM).Methods A total of 982 consecutive patients with HCM at the National Center for Cardiovascular Diseases (China) from October 2009 to December 2013 were included in the present study,and followed up till the end of December 2016.The patients were divided into three groups according to the levels of free triiodothyronine (FT3):the group 1 (FT3≤4.28 pmol/L,n=335),the group 2 (FT3＞4.28-＜4.79 pmol/L,n=310),and the group 3 (FT34.79-6.30 pmol/L,n=337).Results After a follow-up period of (53.8 ± 14.1) months,39 patients (4.0％) either suffered death with all causes or received a cardiac transplantation (7.8％,2.9％ and 1.2％ of the patients in the group 1,group 2 and group 3,respectively).A multivariable Cox regression analysis revealed that FT3≤4.28 pmol/L was associated with a significantly higher risk of all-cause mortality or cardiac transplantation (HR 8.83,95％ CI 1.115-69.905,P=0.039) in HCM patients.Conclusions Low levels of FT3 is a risk factor of adverse events for patients with HCM,indicting a role of FT3 as a marker for assessing the risk of long-term adverse events in these patients.

Objective: This cross-sectional study aimed to address the relationship between the volume of epicardial adipose tissue (EAT) with cardiovascular risk factors and coronary artery calcification(CAC) in the community residents. Methods: Individuals were recruited from the Jidong Community (Tangshan City, Northern China) which mainly comprised employees of the Jidong Co. Ltd. and their family members. From July 2013 to August 2014, 2 647 participants aged ≥40 years were included in this study. The volume of EAT and coronary artery calcification score (CAC score) were determined by a 64-slice CT. Carotid intima-media thickness (CIMT) was measured by a trained sonographer using a high-resolution B-mode topographic ultrasound system. Venous blood samples were analyzed by automated analyzers in the central laboratory. A validated questionnaire specifically designed for this study was used to collect demographic data from all participants by trained doctors. Characteristics of study cohort were compared according to quartiles of EAT volume (n=660, 663, 662, 662, repectively). Results: (1) The mean age of participants was (55.31±7.76) years and 49.94% (n=1 322) were men. The median EAT volume (interquartile) was 129.42 (95.66, 176.51)cm³. (2) Age, BMI, waist circumference and hip circumference, systolic blood pressure, LDL-C, triglycerides, and fasting blood glucose were significantly higher, while HDL-C level was significantly lower in participants with higher EAT volume than participants with lower EAT volume (all P<0.05). Carotid intima-media thicken (CIMT) and higher CAC score were also significantly higher in participants with higher volume of EAT. Furthermore, percentage of diabetes mellitus, hypertension, hyperlipidemia increased in proportion with increasing EAT volume (P<0.05). (3) In the linear regression, significant positive relations were found for age (β=0.019 3, 95%CI 0.017-0.021, P<0.001), waist circumference (β=0.012 7, 95%CI 0.009-0.016, P<0.001), BMI (β=0.022 4, 95%CI 0.013-0.032, P<0.001), LDL-C (β=0.048 4, 95%CI 0.021-0.076, P<0.001), and HDL-C (β=-0.098 1, 95%CI-0.164--0.032, P<0.001) was inversely related to the EAT volume. (4) Logistic regression analysis indicated that EAT volume was an independent risk factor for CAC score>0 (OR=1.233, 95%CI 1.205-1.262, P<0.001) . Conclusions Our findings indicate that EAT volume is strongly correlated to cardiovascular risk factors and coronary calcification and is an independent risk factor of increased coronary calcification in community residents.

Objective: To determine the value of N-terminal pro-B-type natriuretic peptide (NT-proBNP) on predicting the long-term outcome of patients with hypertrophic cardiomyopathy (HCM) . Methods: NT-proBNP was measured in 831 consecutive patients with HCM at Fuwai Hospital from October 2009 to December 2013 and patients were followed up clinically for (53.3±15.4) months. Patients were divided into 3 groups according to NT-proBNP values: NT-proBNP<860 pmol/L (n=276) , 860 pmol/L≤NT-proBNP≤1 905 pmol/L (n=278) , NT-proBNP>1 905 pmol/L (n=277) . The related baseline data, laboratory examination and echocardiographic results were compared among groups. The primary endpoints of this study were all-cause mortality and cardiac transplantation. Cox proportional hazards model was used to estimate hazard ratio (HR) . Kaplan-Meier analysis was used to evaluate the survival status of patients among the 3 groups. Results: During a median follow-up of (53.3±15.4) months, all-cause mortality or cardiac transplantation occurred in 37 patients (4.5%) , event rate was 1.4% (4/276) , 4.0% (11/278) and 7.9% (22/277) in patients with NT-proBNP<860 pmol/L, 860 pmol/L≤NT-proBNP≤1 905 pmol/L and NT-proBNP>1 905 pmol/L, respectively. Multivariable Cox regression analysis identified that age (HR 1.066, 95%CI 1.027-1.107) and NT-proBNP (HR 1.026, 95% CI 1.010-1.042) were independent predictors of all-cause mortality or cardiac transplantation. Among the 3 groups, the survival rate of the NT-proBNP<860 pmol/L group was the highest,and that of the NT-proBNP>1 905 pmol/L group was the lowest (P<0.01) . Conclusions The level of NT-proBNP provides clinically relevant information for long-term adverse events risk stratification in patients with HCM.

Objective To establish a method of gold nanoprobe-based solution hybridization (GNBSH) to detect nucleic acid sequence-based amplification (NASBA) products for the rapid diagnosis of invasive aspergillosis (IA).Methods The Aspergillus specific 18S rRNA was amplified by NASBA and then the amplified products were hybridized with the gold nanoprobes which were modified with thiol compounds at the 5'end.Serum samples from 106 patients,including 14 with a definite IA,32 with suspected IA and 60 without IA,were detected by the established method,and the obtained results were compared with that of galactomannan (GM) test to evaluate its accuracy.Results The gold nanoprobes only hybridized with Aspergillus NASBA products but not other non-Aspergillus strains.The sensitivity,specificity and the area under the ROC curve (AUCROC) of the established GNBSH method for detecting 106 clinical samples were 82.61％ (38/46),81.67％ (49/60) and 0.890,respectively.The sensitivity,specificity and AUCROC of GM test were 56.52％ (26/46),83.33％ (50/60) and 0.723,respectively.Conclusion The established GNBSH method to detect Aspergillus NASBA products has high sensitivity and specificity and simple operation,which may be used to detect the infection of Aspergillus by clinical laboratories.