Objective To investigate prognostic value of serum levels of cathepsin B(CTSB)and NADPH oxidase 4(NOX4)in patients with sepsis associated acute kidney injury(S-AKI).Methods A total of 306 pa-tients with sepsis treated to the hospital from June 2023 to June 2024 were selected,including 192 patients with S-AKI(S-AKI group)and 114 patients without S-AKI(non-S-AKI group).According to the prognosis of S-AKI patients,they were divided into poor prognosis group(n=127)and non-poor prognosis group(n=65).The differences of CTSB and NOX4 in different groups were compared.Pearson analysis was conducted to analyze the correlation between CTSB,NOX4 and clinical indicators.The influencing factors of poor prognosis in S-AKI patients was analyzed according to multivariate Logistic regression.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of CTSB and NOX4 on the poor prognosis of S-AKI pa-tients.Results Th e serum levels of CTSB,NOX4 and serum creatinine(SCr)in S-AKI group were signifi-cantly higher than those in non-S-AKI group(P＜0.05),while the mean arterial pressure and oxygenation in-dex were lower than those in non-S-AKI group(P＜0.05).Serum levels of CTSB and NOX4 in patients with sepsis were positively correlated with SCr(P＜0.05).Compared to non-poor prognosis group,the age,SCr,CTSB and NOX4 of patients in the poor prognosis group were higher,while the mean arterial pressure and ox-ygenation index were lower(P＜0.05).The increased mean arterial pressure and oxygenation index were pro-tective factors for poor prognosis in S-AKI patients(P＜0.05),and the increased age,SCr,CTSB and NOX4 levels were risk factors for poor prognosis in S-AKI patients(P＜0.05).ROC curve showed that the area un-der the curve(AUC)of CTSB combined with NOX4 was significantly higher than AUC of single detection of CTSB and NOX4(Z=4.066,P＜0.001,Z=3.801,P＜0.001).Conclusion The serum levels of CTSB and NOX4 in S-AKI patients are elevated,and can indirectly reflect kidney function.CTSB combined with NOX4 can significantly improve the prediction efficiency of poor prognosis in S-AKI patients,which has potential ap-plication value for clinical treatment and nursing.

Objective To compare the results of accumulation and continuation methods in indoor radon measurement. Methods The radon concentrations in 30 households in 7 provincial capital cities of China were simultaneously measured using both accumulation and continuation methods. Results The radon concentration measured by accumulation method in 30 households ranged from 21 to 323 Bq/m³, with a median M(P₂₅, P₇₅) of 70.5 (43.8, 111). The radon concentration measured by the continuation method ranged from 16.1 to 258 Bq/m³, with a median M(P₂₅, P₇₅) of 100 (51.3, 141). The average relative percent deviation between the two measurement methods was 41.8%. There were significant differences among the measurement results at 8, 16, and 24 h by the continuation method. Pairwise comparisons showed there were statistical diffferences between 8 h and 16 h, as well as between 8 h and 24h; however, no statistical significance was found (P < 0.05), between 16 h and 24 h. Conclusion The overall continuous measurement results of the 30 households were higher than those of cumulation method. The comparison between accumulation and continuation measurement results did not show a high level of correlation (r=0.49). The continuation method is significantly affected by environmental factors, and the length of the measurement period can affect the measurement results. The selection of indoor radon measurement methods should consider the purpose, sample size, and environmental conditions.

Objective To investigate the expression and clinical significance of extracellular nicotinamide phosphate ribose transferase(eNAMPT)and soluble programmed death ligand 1(sPD-L1)in serum of pa-tients with sepsis secondary to severe pancreatitis(SAP).Methods A total of 92 SAP patients admitted to the hospital from February 2019 to February 2022 were selected as(SAP grou),and divided into a sepsis group(42 cases)and a non-sepsis group(50 cases).Moreover,50 patients with mild to moderate pancreatitis who were diagnosed and treated at the same time were selected as the disease control group,and 50 healthy in-dividuals who underwent the physical examination in the hospital during the same pariod were selected as the healthy control group.Enzyme linked immunosorbent assay was used to detect serum levels of eNAMPT and sPD-L1.Pearson correlation analysis was used for correlation analysis.Multivariate Logistic regression analy-sis was used to analyze factors affecting the occurrence of secondary sepsis in SAP.The predictive value of ser-um eNAMPT,sPD-L1 and their combination in the secondary sepsis of SAP was conducted by receiver operat-ing characteristic(ROC)curve.Results The serum levels of eNAMPT and sPD-L1 in the SAP group were higher than those in the disease control group and the healthy control group,and the differences were statisti-cally significant(P＜0.05).The Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score,Sequential Organ Failure Assessment(SOFA)score,white blood cell count,C-reactive protein,pancreatic nec-rosis,systemic inflammatory response syndrome,multiple organ failure,serum eNAMPT and sPD-L1 in the sepsis group were higher than those in the non-sepsis group,and the differences were statistically significant(P＜0.05).There was a positive correlation between serum eNAMPT,sPD-L1 and APACHE Ⅱ score,SOFA score in sepsis SAP patients(P＜0.05).Serum eNAMPT and sPD-L1 were independent risk factors for sec-ondary sepsis in SAP patients.The area under the curve(AUC)of the combination of serum eNAMPT and sPD-L1 for predicting secondary sepsis in SAP patients was 0.916(95％CI:0.868-0.947),which was signif-icantly larger than 0.846(95％CI:0.791-0.879)and 0.830(95％CI:0.774-0.861)of the single indicator detections,and the differences were statistically significant(Z=4.129,4.885,P＜0.001).Conclusion The serum eNAMPT and sPD-L1 levels in patients with sepsis secondary to SAP are elevated,which are related to the severity of the disease.The combination of serum eNAMPT and sPD-L1 has high predictive value for sec-ondary sepsis in SAP.

OBJECTIVE: We aimed to analyze the current indoor radon level and estimate the population risk of radon-induced lung cancer in urban areas of China. METHODS: Using the passive monitoring method, a new survey on indoor radon concentrations was conducted in 2,875 dwellings across 31 provincial capital cities in Chinese mainland from 2018 to 2023. The attributable risk of lung cancer induced by indoor radon exposure was estimated based on the risk assessment model. RESULTS: The arithmetic mean (AM) and geometric mean (GM) of indoor radon concentrations were 65 Bq/m³ and 55 Bq/m³, respectively, with 13.6% of measured dwellings exceeding 100 Bq/m³ and 0.6% exceeding 300 Bq/m³. The estimated number of lung cancer deaths induced by indoor radon exposure was 150,795, accounting for 20.30% (95% CI: 20.21%-20.49%) of the lung cancer death toll. CONCLUSION This study provided the most recent data on national indoor radon levels in urban areas and the attributable risk of lung cancer. These results served as an important foundation for further research on the disease burden of indoor radon exposure and radon mitigation efforts.
Radon/analysis* ; China/epidemiology* ; Air Pollution, Indoor/analysis* ; Lung Neoplasms/etiology* ; Humans ; Cities/epidemiology* ; Air Pollutants, Radioactive/adverse effects* ; Neoplasms, Radiation-Induced/etiology* ; Risk Assessment ; Radiation Monitoring

Objective To investigate the current status of unplanned readmission to the ICU in neurosurgical patients and to study its influencing factors,aiming to inform the construction of targeted nursing interventions for medical staff.Methods From January 2020 to September 2022,the relevant data of patients transferred out from the ICU of a tertiary-level hospital in Beijing were retrospectively analyzed.After using propensity score matching,a sample with balanced covariates between groups was obtained,and single-factor and Logistic regression analyses were used to study the influencing factors of unplanned readmission to the ICU in neurosurgical patients.Results The data of a total of 4 789 patients were included,and 159 patients(3.32％)had unplanned readmission to the ICU.Respiratory failure and pulmonary infection were the main respiratory complications causing unplanned readmission to the ICU in neurosurgical patients.Logistic regression analysis showed that the duration of mechanical ventilation,the length of the first stay in the ICU,tracheal intubations ≥2 times,presence of cerebrospinal fluid drainage tube or lumbar drainage tube,existence of mild to moderate consciousness disorder at discharge from ICU,low white blood cell count,and low hemoglobin count were independent influencing factors for unplanned readmission to ICUs in neurosurgical patients(P＜0.05).Conclusion Medical staff should pay attention to the high-risk group of unplanned return to the ICU,assess the risk of transfer in a timely manner,carry out targeted nursing measures and strengthen the quality of nursing care to reduce the incidence of unplanned retum to the ICU in neurosurgical patients.

Objective To investigate the current status of unplanned readmission to the ICU in neurosurgical patients and to study its influencing factors,aiming to inform the construction of targeted nursing interventions for medical staff.Methods From January 2020 to September 2022,the relevant data of patients transferred out from the ICU of a tertiary-level hospital in Beijing were retrospectively analyzed.After using propensity score matching,a sample with balanced covariates between groups was obtained,and single-factor and Logistic regression analyses were used to study the influencing factors of unplanned readmission to the ICU in neurosurgical patients.Results The data of a total of 4 789 patients were included,and 159 patients(3.32％)had unplanned readmission to the ICU.Respiratory failure and pulmonary infection were the main respiratory complications causing unplanned readmission to the ICU in neurosurgical patients.Logistic regression analysis showed that the duration of mechanical ventilation,the length of the first stay in the ICU,tracheal intubations ≥2 times,presence of cerebrospinal fluid drainage tube or lumbar drainage tube,existence of mild to moderate consciousness disorder at discharge from ICU,low white blood cell count,and low hemoglobin count were independent influencing factors for unplanned readmission to ICUs in neurosurgical patients(P＜0.05).Conclusion Medical staff should pay attention to the high-risk group of unplanned return to the ICU,assess the risk of transfer in a timely manner,carry out targeted nursing measures and strengthen the quality of nursing care to reduce the incidence of unplanned retum to the ICU in neurosurgical patients.

Objective To investigate the indoor radon concentration and its changing trend in northeastern China. Methods We measured indoor radon levels cumulatively for over three months by solid state nuclear track detection in a total of 261 houses in multi-story or high-rise buildings in Shenyang, Changchun, Harbin, Heihe, and Yichun in northeastern China. The measurement lasted one year in Changchun for seasonal changes. Results The average indoor radon concentration in the five cities was 88 Bq/m³, ranging from 12 to 558 Bq/m³. The indoor radon concentrations were ≤ 100 Bq/m³ in 75.1% of the houses, and ≤ 300 Bq/m³ in 97.7% of the houses. The indoor radon concentration increased with the age of buildings. The indoor radon concentration was highest in winter, and it was higher in summer than in autumn and spring. Conclusion The indoor radon concentration in northeastern China increased compared with the data of 1980s and 1990s. It is highest in the winter heating season, and higher in summer than in spring and autumn. Indoor radon exposure deserves attention.

Objective:To deeply explore the pain experience of patients with rheumatoid arthritis, so as to provide a basis for the practical interventions in the next step.Methods:Using the phenomenological research method, 18 patients with rheumatoid arthritis who experienced pain in the First Hospital of Soochow University from September 2020 to January 2021 were selected for semi-structured interviews, and the Colaizzi 7-step analysis method was used for data analysis.Results:The pain experience of patients with rheumatoid arthritis were summarized into six themes. Pain was complex and erratic, pain relief strategies were ineffective, pain negatively affected daily life, expected more pain relief, seeking help selectively when pain occurs, and experienced pain brings positive change.Conclusions:Medical staff must pay attention to the real experiences and demands of pain in rheumatoid arthritis patients, use information technology and multidisciplinary collaboration to provide patients with effective pain management strategies and encourage patients to make more positive changes to relieve pain symptoms.

Objective:To obtain the distribution characteristics of radon levels in drinking water in cities of China and analysis their influencing factors.Methods:A total of 31 cities were selected and 406 tap water samples were collected in accordance with the sampling plan based on administrative division. Radon concentrations in the water samples were determined by using RAD7 H 2O measuring devices, and the closed loop liquid-gas balance method and grab method . The radon concentrations in the gas loop were measured by using semiconductor detector. After four measurement periods, radon concentrations in water were calculated. Results:The arithmetic mean of radon concentrations in drinking water from 31 cities was (4.92±9.44) Bq/L and the geometric mean (0.71±7.77) Bq/L, ranging from less than the lower detection limit (LLD) to 43.15 Bq/L. For 84.2% of drinking water samples, radon concentrations were less than US EPA recommended 11.1 Bq/L, all lower than the EU-recommended value of 100 Bq/L.Conclusions:The radon concentrations in drinking water are higher in northeastern, northwestern, southwestern, northern China than those in southern, central China and eastern China. The factors influencing radon concentrations in drinking water are closely related to geological structure and water source type. Compared with the global values, the radon concentrations in drinking water in our cities are low and safe in general in China.

Objective To explore the source and control of radon in high radon houses in geothermal fields; Methods Radon concentration in indoor and soil was measured by ATD detector in winter and summer; radionuclides in building materials were measured by gamma-ray spectrometry; radionuclides dose rates of building materials were measured by 6150 A D/ 6H X-γ ray detector; and radon reduction technology was applied to one of the houses;Results The average radon concentrations in 32 rooms were （106.4 ± 63.7） Bq/m³ (summer) and （421.3 ± 138.2） Bq/m³ (winter), and the concentrations in 12.5% (summer) and 96.9% (winter) of the rooms exceed 150 Bq/m³. The average radon concentration in soil around buildings was 12890 Bq/m³ (n = 24), which is 1.7 times of the typical soil radon concentration in Beijing (7600 Bq/m³). After soil decompression, the radon concentration in the house could be reduced to less than 100 Bq/m³. The radon reduction rates of active decompression and passive decompression were 94.6% and 71.4%, respectively. Conclusion The effect of soil decompression on reducing radon concentration in the bottom rooms is obvious. Attention should be paid to the radon in residential environment of geothermal field.