Objective:To investigate the development and influencing factors of frailty in elderly patients on maintenance hemodialysis.Methods:A cross-sectional survey involved 146 elderly patients on maintenance hemodialysis at the blood purification department of the First Affiliated Hospital of Xi'an Jiaotong University.A self-designed demographic questionnaire was used to collect general information of patients, the Simple Physical Performance Scale(SPPB)was used to assess physical function, the 5-item SARC-F was used as a tool for rapid screening of sarcopenia, and the Hospital Anxiety and Depression Scale(HADS)was used for screening of anxiety and depression.The FRAIL scale was used for frailty assessment and participants were divided into a no frailty group, a pre-frailty group and a frailty group according to different frailty scores.Relevant influencing factors of frailty were analyzed.Results:Among 146 hemodialysis patients, 33(22.6%)were in the non-frailty group, 86(58.9%)in the pre-frailty group, and 27(18.5%)in the frailty group.Univariate analysis showed that there were statistically significant differences in sex( χ2=6.220, P=0.045), age( F=5.197, P=0.007), body type( χ2=31.927, P<0.001), SARC-F score( χ2=24.283, P<0.001)and SPPB score( χ2=26.773, P<0.001)between different groups.There were 3 patients(9.4%)at high risk for sarcopenia in the no frailty group, 13 patients(40.6%)at high risk for sarcopenia in the pre-frailty group, and 16 patients(50%)at high risk for sarcopenia in the frailty group, and differences in the occurrence of sarcopenia between the different subgroups of frailty were statistically significant( χ2=27.496, P<0.001). Multifactorial Logistic regression analysis showed that age, ( OR=1.04, 95% CI: 0.99-1.08, P=0.049), sex( OR=0.39, 95% CI: 0.17-0.87, P=0.021), body size( OR=0.07, 95% CI: 0.01-0.50, P=0.008), SARC-F( OR=0.14, 95% CI: 0.05-0.38, P<0.001)were independent influencing factors of frailty in elderly maintenance hemodialysis patients( P<0.05). Conclusions:The incidence of frailty is high in elderly patients on maintenance hemodialysis, and the development of frailty is affected by age, body mass index and sarcopenia.

Objective:To investigate the clinical effect on ultrasound-guided vascular access-interventional therapy of hemodialysis in day surgery mode.Methods:Hemodialysis patients with vascular access dysfunction who underwent ultrasound-guided interventional therapy in the First Affiliated Hospital of Xi'an Jiaotong University from September 1, 2018 to October 31, 2020 were retrospectively analyzed. Demographic and clinical data were collected by electronic medical record system and telephone follow-up. Kaplan-Meier method was used to analyze the patency rate of vascular access.Results:A total of 421 cases of ultrasound-guided vascular access intervention were performed in 269 patients. The technical success rates of stenosis, chronic occlusion and acute occlusion lesion were 98.8%, 90.6% and 86.4%, respectively, and 406 cases (96.4%) of 246 patients were clinically successful. The postoperative brachial artery blood flow was 821(627, 1 029) ml/min, which was significantly higher than 309(202, 453) ml/min before the operation ( Z=-13.547, P<0.001). No serious complications occurred during and after the operation. At 6, 12, 18 and 24 months after operation, the primary patency rate was 74%, 59%, 48% and 45%, respectively, the assisted primary patency rate was 94%, 91%, 88% and 82%, and the secondary patency rate was 96%, 93%, 91% and 86%. Compared with the conventional inpatient surgery mode, the total cost of the day surgery mode was significantly reduced [12 067(10 051, 13 198) yuan vs 14 986(12 411, 20 643) yuan, Z=-13.185, P<0.001], and the hospital stay was significantly shortened [5.1(3.5, 6.9) h vs 73.4(31.6, 146.6) h, Z=-13.348, P<0.001]. Conclusion:It is safe and effective to perform interventional therapy for vascular access malfunction under ultrasound in day surgery mode, which can save cost and time of hospitalization, and can be carried out in hospitals with relevant conditions.

Objective:To construct an integrated medical care service mode in hemodialysis and explore the application effect of the concept of integrated medical service in hemodialysis patients.Methods:In 2016,100 patients who had regular hemodialysis(lasting for more than 3 months) were selected from July to Septembe ras the control group,while another100 patients who had the regular hemo dialysis (lasting for more than 3 months) and received the concept of integrated medical care service were selected from October to December as the observation group.The treatment compliance,the incidence of hemodialysis complications,and patient satisfaction of twogroups were compared.Results:Both the treatment compliance and patient satisfaction of the participants in the observation group were significantly higher than those in the control group (P ＜ 0.05),while the incidence of hemodialysis complications in the observation group was significantly lower than that in the control group (P ＜ 0.05).Conclusion:The implementation of integrated medical careservice concept can fully deepen the service concept of people-oriented and patient-centered,carry out humanized services,improve the treatment compliance of hemodialysis patients,reduce the complications,promote the cooperation of doctors and nurses,enhance the effect of health education,and improve the patient satisfaction.

Objective To understand the epidemic situation and influencing factors of malaria in Jiangsu Province and grasp its epidemic regularity and trend. Methods According to the malaria prevalence in Jiangsu Province,6 counties(city,dis-trict)including Yixing,Suining,Wujin,Hai’an,Ganyu and Xuyi were selected as provincial surveillance sites to survey malar-ia epidemic conditions. The basic information,blood test results of fever patients,case investigation information of malaria pa-tients,monitoring data of investigation and disposition of the malaria focus were collected and analyzed. Results In 2013,the blood tests of 66 723 fever patients were performed,the average blood smear checking rate was 1.10%,and the average positive rate was 0.08%(52 plasmodium positive individuals)in the 6 areas. For these 52 plasmodium positive individuals,the blood re-tests and case investigations were completed within 3 days after these cases were reported by the network system,and the investi-gation confirmed that they were foreign imported malaria cases. The malaria focus investigation and disposition were finished within 1 week and the data were reported by the Parasitic Diseases Information System. Four of 52 cases were recrudescence dur-ing the follow-up. Among the 52 cases,20 people went abroad themselves and 4 were labors of private enterprises,21 people came back without the accompanied. Conclusions With the development of the malaria elimination program in Jiangsu Prov-ince,the eliminating malaria“targeted 1-3-7”working pattern has been comprehensively implemented. The personnel monitor-ing for labors who returned from overseas working will be a key in the future.

Objective To observe the residual effect of Demand CS - impregnated bednets to Anopheles sinensis.Methods The numbers of adult mosquitoes which were knocked down at every minute after treatment were observed by using the enforced contact method recommended by WHO,and the mortality of mosquitoes tested after 24 h was calculated.Results The Kt_(50) of Demand CS - impregnated bednets with impregnations concentrations of 10,15,20 mg/m~2 to Anopheles sineasis were 21.40,16.20,15.70 min,respectively,and the 24 h mortality was 100%.The Kt_(50) of Responsar SC (12.5 % Beta - cyfluthrin) impregnated bednets with a impregnation concentration of 15 mg/m~2 to Anopheles sinensis was 16.06 min,and the 24 h mortality was 100%,too.Conclusions Both the Demand CS - impregnated bednets and the Responsar SC impregnated bednets can kill Anopheles sinensis.

Objective To establish a simple,convenient,quick and high sensitive method of loop-mediated isothermal amplification (LAMP) for detection of Plasmodium vivax-carrying mosquitoes.Methods The species conservative regions of P.v CSP gene were selected to design 2 pairs of primers which recognized 6 distinct regions.To evaluate the specificity of detection by LAMP,infected Anopheles,An.sinensis (An.s),Plasmodium falciparum (P.f),and healthy human blood DNA were selected as templates.To assess the sensitivity of detection,1.3×10~6,1.3×10~5,1.3×10~4,1.3×10~3,1.3×10~2,1.3×10~1 and 1.3×10~0 copies of P.v CSP plasmid DNA mixed with 1.0 μl An.s DNA were used as the templates of LAMP.The infected An.s DNAs were diluted with negative An.s DNA by 1:2,1:4,1:8,1:16,1:32,1:64,1:128 and 1:256 and then detected by LAMP to show the sensitivity of batch quantity detection.The applied value of this method was evaluated by detecting the same batch of 67 artificial infected An.s mosquitoes,and compared with the detection of microscopic examination and nested PCR in parallel.Results By using LAMP,the detection of infected An.s was positive,while the control samples were all negative.The limits of detection of different proportion dilutions of the mixture of P.v CSP plasmid DNA with An.s DNA were 1.3×10~2 copies.The limits of detection of different proportion dilutions of the mixture of infected An.s DNA with An.s DNA were 1:128.The positive rate of detecting the same batch of 67 artificial infected mosquitoes was 47.76% by LAMP,25.37% by the microscopic examination (X~2 = 7.24,P<0.01),40.30% by nested PCR (X~2 = 0.73,P>0.05).Compared with the test of the microscopic examination and then with a statistical analysis,the sensitivity of LAMP was 100%,which agreed well with the sensitivity of nested PCR (100%).Conclusion The method of LAMP is simple,convenient and high sensitive,and it is a potential method for detecting Plasmodium vivax-carrying mosquitoes in the field.

Objective To explore the sample reIated factors affecting the short-term culture of erythrocytic Plasmodium dvax in vitro.Methods The vivax malaria blood samples were collected from the patients with malaria in endemic areas,and then incubated with McCoy's 5A medium in an incubator containing 5%CO_2 at 37℃.The factors affecting the short-term culture of Plasmodium vivax were analyzed.Results Plasmodium vivax could finish one asexual cycle in the selected medium.By analyzing the culture results of 74 samples.it was found that the factors affecting the short-term culture included long time delaying al room temperature(>4 h),single stage(only parasites in ring stage were found),patients taking antimalarials,antibiotics or sulfonamides.and low parasitemia.Conclusion The sample related factors are important to the short-term culture of erythrocytic Plasmodium vivax in vitro.

Objective To analyse the epidemic characteristics and control measures of malaria in Jiangsu Province during the past fifty years, evaluate the control effect and explore the current appropriate control strategy and measures. Methods The historical data about malaria cases and control measures from 1951 to 2008 in Jiangsu Province were collected, and the effects of malaria control in different stages were assessed. Results The integrated control measures with emphasis on the control of infectious source were adopted during the stage of two outbreaks of malaria. In the stage of basical elimination of malaria, the comprehensive measures with emphasis on the vector control in the areas of Anopheles anthropophagus were adopted, and the measures with emphasis on the surveillance of infectious source surveillance and early treatment of malaria in other areas were adopted. In the stage of consolidation, the measures including the surveillance of infectious source and management, surveillance of vector and epidemic situation, management of floating population, etc, were adopted. The malaria incidence dropped from 2 495/10 000 in 1960 to 0.09/10 000 in 2008, and was under 1/10 000 in all the counties of Jiangsu Province during the past 2 years, which demonstrated the various measures were feasible and effective in different stages of malaria. Conclusions Malaria has been controlled effectively in Jiangsu Province, however, the improvement of early diagnosis and norm treatment of malaria cases, the enhancement of health education and promotion, as well as the malaria surveillance and management among floating population, are still necessary for achieving the goal of malaria elimination.

Objective To analyze the genetic characteristics of ribosomal DNA ITS 2 region for differenciating anopheline mosquitoes within Hyrcanus group. Methods The ribosomal DNA ITS 2 region of both laboratory line and filed collected An. anthropophagus and An. sinensis as well as the field collected An. yatsushiroensis and An. lester i were amplified and sequenced. The sequencing data were then analyzed for the restriction mapping using Omega Sequencing analysis program. Results and Conclusion The length of the sequences of An. sinensis, An. anthropophagus, An. yatsushiroensis and An. lesteri are 472, 452, 456 and 456 bp respectively. The restriction mapping showed that there were different restriction digesting sites among the ribosomal DNA ITS2 region sequences from An. sinensis, An. anthropophagus, An. yatsushiroensis and An. lesteri . On the basis of the sequence differences among the anopheline species within Hyrcanus group, it is possible to develop new technique for genetic identification of anopheline mosquitoes.

Objective To study the relationship between P450 (CYP6 and CYP4) genes and deltamethrin resistance in Anopheles anthropophagus. Methods The real-time RT-PCR technique was used for semi-quantitative analysis of mRNA copy numbers of CYP6 and CYP4 gene from susceptible and deltamethrin-resistant strains. Results It is found that the mRNA copy numbers of CYP6 gene in deltamethrin-resistant strain were about 1. 39 times higher than those in susceptible strain, and the mRNA copy numbers of CYP4 gene in deltamethrin-resistant strain were about 3. 63 times higher than those in susceptible strain of Anopheles anthropophagus. Conclusion The higher expressions of CYP6 and CYP4 mRNA are observed in deltamethrin resistance strain and indicate that both CYP6 and CYP4 genes may be involved in the deltamethrin resistance in Anopheles anthropophagus.