Background The detection rates of Legionella pneumophila in metro cooling tower water in various cities are relatively high, while studies investigating the trends of Legionella pneumophila pollution and analyzing its influencing factors are still limited. Objective To investigate the status of Legionella pneumophila contamination in the water of metro cooling towers in a city, to analyze its influencing factors, and to provide a basis for preventing and controlling Legionella pneumophila contamination in metro cooling tower water. Methods After categorizing the metro lines into three groups (>10 years, >5-10 years, and ≤5 years) according to the operating years of each metro line in a city, we randomly selected one line from each group and the selection resulted a total of 58 cooling towers. We collected water samples from the cooling towers during the early, middle, and late stages of cooling tower operation to detect Legionella pneumophila and water quality related indicators. Information on the environment and hygiene management measures of the cooling towers was obtained through on-site investigation and questionnaire survey. Generalized mixed linear models were used to analyze the influencing factors of Legionella pneumophila contamination in cooling tower water. Results The detection rates of Legionella pneumophila in the early, middle, and late stages of cooling tower operation were 25.9%, 77.6%, and 81.0%, respectively. The detection rates in the middle and late stages of operation were significantly higher than that in the early stage (P<0.001). The results of generalized mixed linear regression showed that the total dissolved solids and conductivity were positively associated with positive Legionella pneumophila. For each unit increase in ln-transformed total dissolved solids and conductivity, their ORs (95%CIs) were 3.73 (1.19, 11.69) and 3.62 (1.07, 12.25), respectively. Nitrates, sulfates, and free residual chlorine were negatively associated with positive Legionella pneumophila. For each unit increase in ln-transformed nitrates and sulfates, their ORs (95%CIs) were 0.52 (0.34, 0.80) and 0.54 (0.36, 0.81), respectively. Compared with the group with 0-0.04 mg·L⁻¹ of free residual chlorine, the ORs (95%CIs) for the groups with 0.05-0.30 mg·L⁻¹ and ≥0.31 mg·L⁻¹ of free residual chlorine were 0.22 (0.07, 0.74) and 0.01 (0.01, 0.19), respectively. Nitrates, sulfates, and free residual chlorine were negatively associated with the concentration of Legionella pneumophila. For each unit increase in ln-transformed nitrates and sulfates, the βs (95%CIs) of Legionella pneumophila concentration were −1.17 (−1.59, −0.74) and −1.11 (−1.63, −0.58), respectively. Compared with the group with 0-0.04 mg·L⁻¹ of free residual chlorine, the β (95%CI) was −5.66 (−9.45, −1.87) for the group with ≥0.31 mg·L⁻¹ of free residual chlorine. Conclusion The metro cooling tower water in the selected city is seriously contaminated by Legionella pneumophila, and getting further aggravated as the cooling tower annual operation time increases. Total dissolved solids, conductivity, nitrates, sulfates, and free residual chlorine are the major influencing factors for positive Legionella pneumophila, and nitrates, sulfates, and free residual chlorine are the major influencing factors for the concentration of Legionella pneumophila.

Objective:To investigate the knowledge of Sixth Chinese national consensus report on the management of Helicobacter pylori infection ( treatment excluded) (hereinafter referred to as sixth national consensus) and 2022 Chinese national clinical practice guideline on Helicobacter pylori eradication treatment (hereinafter referred to as the guideline)among medical staff from general hospitals in Hainan. Methods:From February 20 to May 7, 2023, a questionnaire survey on the diagnosis and treatment of Helicobacter pylori ( H. pylori) infection was conducted among 1 463 medical staff from 15 general hospitals in Hainan Province. The questionnaire was drawn up according to the sixth national consensus and the guideline, covering knowledge of 6 sections, induding H. pylori related diseases, detection of H. pylori, eradication, prevention and influence factors of eradication of H. pylori, etc. Chi-square test was used for statistical analysis. Results:A total of 1 463 valid questionnaires were collected with the effective responsive rate of 100.00%.The 1 463 subjects included 225 gastroenterologists and 1 238 other medical staff(including 503 physicians from other departments, 264 surgeons and 471 medical technologists and pharmacists). About 78.67%(177/225)of gastroenterologists agreed that the overall infection rate of H. pylori in China was more than 20%, the awareness rate was higher than that of other medical staff (physicians from other departments 65.41%(329/503), surgeons 61.74%(163/264), medical technologists and pharmacists 60.30%(284/471); the following datas were sorted by this position), and the difference was statistically significant ( χ2=30.97, P<0.001). About 51.11%(115/225) of gastroenterologists considered that H. pylori serological antibody test could not be used as a diagnostic method for current infection, the awareness rate was higher than that of other medical staff(22.07%(111/503), 14.02%(37/264), 12.31%(58/471)), and the difference was statistically significant( χ2 =152.66, P<0.001). Proton pump inhibitor and potassium-competitive acid blocker should be discontinued for 2 weeks, and antibiotics and bismuth should be discontinued for 4 weeks before urea breath test, and the awareness rates of gastroenterologists were higher than those of other medical staff (38.67%(87/225) vs. 23.26%(117/503), 19.70%(52/264), 18.47%(87/471); 60.89%(137/225) vs. 26.64%(134/503), 25.76%(68/264), 23.78%(112/471)), and the differences were statistically significant ( χ2 =133.70 and 165.51, both P<0.001). For refractory H. pylori infection, 98.67%(222/225)of gastroenterologists agreed with the individualized diagnosis and treatment of H. pylori infection should be guided by bacterial culture, antibiotic susceptibility test or drug resistance gene test, and the awareness rate was higher than that of other medical staff (91.85%(462/503), 93.56%(247/264), 93.21%(439/471)), and the difference was statistically significant( χ2=20.55, P=0.002). About 70.67% (159/225) of gastroenterologists recommended a bismuth containing quadruple regimen, 80.44% (181/225) supported a 10 to 14 day H. pylori eradication course, and the awareness rates were higher than other medical staff (46.92%(236/503), 33.33%(88/264), 32.91%(155/471); 67.20%(338/503), 59.09%(156/264), 53.93%(254/471)), and the differences were statistically significant ( χ2=111.25 and 59.99, both P<0.001). The understanding rates of the sixth national consensus and the guideline in gastroenterologists was 85.33% (192/225), which was higher than that of other medical staff (64.21%(323/503), 66.67%(176/264), 57.96%(273/471)), and the difference was statistically significant ( χ2=85.47, P<0.001). Conclusions:Gastroenterologists from general hospitals in Hainan Province have a better understanding of the sixth national consensus and the guideline than other medical staff. However, there is still a lack of deep understanding of the sixth national consensus and the guideline, and it is necessary to further strengthen the learning and application of the sixth national consensus and the guideline.

Objective:To investigate the effect of different pressure balloon dilation combined with prying reduction and bone graft fixation in the treatment of thoracolumbar fractures and the risk factors of postoperative re-fracture.Methods:One hundred cases of thoracolumbar fracture patients admitted to Cangzhou Integrated Traditional Chinese and Western Medicine Hospital in Hebei Province from March 2019 to June 2021 were selected. Prospective randomized controlled study method was used and random number table method was used to divide them into three groups: incomplete expansion group (33 cases), moderate expansion group (33 cases) and complete expansion group (34 cases). All the 3 groups were treated with balloon dilation combined with prying reduction and bone graft fixation. The pressure of balloon dilation in incomplete dilation group, moderate dilation group and complete dilation group was 100 psi, 150 psi and no more than 200 psi respectively, and the volume of balloon dilation was 0.5∶1, 1∶1 and 1.5∶1 respectively. The operation time, intraoperative bleeding volume, postoperative drainage volume, vertebral anterior margin recovery rate and hospital stay, as well as local Cobb angle, visual analog scale (VAS) and Oswestry disability index (ODI) scores before and after operation were compared among the three groups. According to the follow-up of whether there is re-fracture after surgery, the clinical data of the re-fracture group and the non re-fracture group were compared, and the risk factors of the re-fracture after surgery were analyzed. The measurement data with normal distribution was expressed as: independent sample t-test was used for comparison between two groups, one-way ANOVA or repeated measurement ANOVA was used for comparison between three groups, and SNK-q test was used for comparison between two groups. Counting data were expressed in cases or cases (%), and compared between groups by χ 2 Inspection. Logistic regression was used to analyze the risk factors of refracture after thoracolumbar fracture. Results:There was no significant difference in operation time, intraoperative blood loss and postoperative drainage volume among the three groups ( P=0.096, 0.328 and 0.344, respectively). The recovery rate of vertebral anterior edge height in moderate expansion group was higher than that in incomplete expansion group and complete expansion group ((84.15±4.21)% vs (70.18±7.44)%, (75.94±6.56)%), and the hospitalization time was shorter than that in incomplete expansion group and complete expansion group ((10.38±2.35) d vs (15.18±3.44), (14.59±2.48) d) (all P<0.001). Before treatment, there was no significant difference in Cobb angle, VAS and ODI scores among the three groups (all P>0.05). After treatment, the Cobb angle, VAS and ODI scores of patients in the three groups were lower than those before treatment, and the moderate expansion group were lower than those in the incomplete expansion group and the complete expansion group ((14.08±2.15) ° vs (16.48±4.85) °, (15.06±3.45) °, (1.81±0.53)% vs (2.25±0.41), (2.31±0.42), (18.16±2.18)% vs (20.48±4.85), (20.01±4.45) points) (all P<0.001). 100 patients were followed up until the fracture was healed. They were divided into re-fracture group (15 cases) and non re-fracture group (85 cases) according to whether there was re-fracture after operation. The results of multifactor logistic regression analysis showed that body mass index and bone mineral density were protective factors for patients with thoracolumbar fracture after operation (odds ratio was 0.66 and 0.15 respectively, 95% confidence interval: 0.51~0.86, 0.05~0.42, P values were 0.006 and <0.001 respectively), The old wedge-shaped change of the vertebral body and the abnormal structure of the lumbar spine are the risk factors for postoperative re-fracture (odds ratio 4.22 and 6.36, 95% confidence interval 1.14-15.56 and 1.43-28.21, respectively, P values were 0.027 and 0.015). Conclusions:In the treatment of thoracolumbar fracture with prying reduction and bone grafting fixation, the effect of balloon expansion pressure of 150 psi is better. Body mass index (BMI) and bone mineral density (BMD) were protective factors for postoperative re-fracture of patients with thoracolumbar fracture. Old wedge-shaped change of vertebral body and abnormal lumbar structure are risk factors for postoperative re-fracture.

Objective:To explore the efficacy of balloon dilation percutaneous kyphoplasty (PKP) combined with prying reduction bone grafting in the treatment of thoracolumbar fractures, and its impact on patients′neurological function.Methods:The clinical data of 184 patients with thoracolumbar fractures from March 2017 to May 2020 in Cangzhou Integrated Traditional Chinese and Western Medicine Hospital of Hebei Province were retrospectively analyzed. Among them, 86 patients were treated with balloon dilation PKP combined with prying reduction and bone grafting (combined group), and 98 patients were treated with open reduction decompression and internal fixation (internal fixation group). The intraoperative bleeding volume, surgical time, intraoperative fluoroscopy frequency, efficacy and complications were recorded. One year after surgery, X-ray films were taken to measure the height of the anterior border and posterior border of vertebral body and the Cobb angle, and the pain visual analogue score (VAS), Barthel index and neurological Frankel grade were evaluated.Results:The intraoperative bleeding volume and surgical time in combined group were significantly higher than those in internal fixation group: (205.64 ± 45.63) ml vs. (180.37 ± 30.08) ml and (110.22 ± 28.91) min vs. (81.66 ± 20.77) min, and there were statistical differences ( P<0.01); there was no statistical difference in intraoperative fluoroscopy frequency between the two groups ( P>0.05). The total effective rate in combined group was significantly higher than that in internal fixation group: 91.86% (79/86) vs. 79.59% (78/98), the total incidence of complications was significantly lower than that in internal fixation group: 13.95% (12/86) vs. 38.78% (38/98), and there were statistical differences ( P<0.05 or <0.01). The height of the anterior border and posterior border of vertebral body 1 year after surgery in combined group were significantly higher than those in internal fixation group: (95.78 ± 1.59) mm vs. (62.74 ± 1.80) mm and (98.53 ± 3.80) mm vs. (95.06 ± 3.28) mm, the Cobb angle was significantly smaller than that in internal fixation group: (6.53 ± 2.80)° vs. (18.06 ± 2.68)°, and there were statistical differences ( P<0.01). The VAS and Barthel index 1 year after surgery in both groups improved significantly, and there were statistical differences ( P<0.01), but there were no statistical differences between the two groups ( P>0.05). The rate of neurological Frankel grade E 1 year after surgery in combined group was significantly higher than that in internal fixation group: 56.98% (49/86) vs. 23.47% (23/98), and there was statistical difference ( P<0.01). Conclusions:Compared with open reduction decompression and internal fixation, the balloon dilation PKP combined with prying reduction and bone grafting patients with thoracolumbar fractures is better for vertebral reduction and deformity repair, with higher safety, more significant pain relief, and better recovery of daily life and neurological function.

Objective:To investigate the clinical features, diagnosis, treatment and prognostic factors of intracranial ependymoma in children.Methods:The clinical data of 32 children with intracranial ependymoma treated in the Department of Neurosurgery, Beijing Children′s Hospital of Capital Medical University from January 2012 to December 2020 were retrospectively analyzed.There were 23 males and 9 females.The median age of diagnosis was 4.5 years old (0.7-10.0 years old). Twelve cases (37.5%) were less than 3 years old and 20 cases (62.5%) were more than 3 years old.Tumors were supratentorial in 14 cases and infratentorial in 18 cases.All patients underwent tumor resection.Eighteen cases received postoperative radiotherapy, and 20 cases received chemotherapy.Four cases took neither radiotherapy nor chemotherapy. Kaplan- Meier method was used to establish the survival curve the intracranial ependymoma patients.Whether the difference of a single variable was significant was examined by the Log- rank test. Results:Of the 32 patients, 30 cases underwent gross total resection and 2 underwent subtotal resection.The mean follow-up time was 24 months (1-62 months). By the time of the last follow-up, 26 cases survived and 6 cases died.The 1-year and 3-year survival rates were 88% and 78%, respectively.Univariate analysis showed that the tumor location ( OR=1.5, 95% CI: 1.082-2.079, P=0.040) greatly affected the overall survival time in children with intracranial ependymoma, and chemotherapy ( OR=0.5, 95% CI: 0.125-1.999, P=0.034) had significant impact on the overall survival time of patients younger than 3 years old. Conclusions:Intracranial ependymoma is more prone to occur in the infratentorial region than the supratentorial region.The tumor location is an important factor affecting the survival of children with ependymoma.For children younger than 3 years old, postoperative chemotherapy can well improve the prognosis, but cannot change the progress of the disease development.

Objective:To explore the application effect of music relaxation therapy based on Swanson's caring theory in breast cancer patients.Methods:A total of 180 breast cancer patients who were admitted to Shanxi Provincial People's Hospital from February 2018 to January 2020 were selected by the convenient sampling method. They were divided into the control group ( n=92) and the observation group ( n=88) according to the random number table method. The control group was given routine nursing, and the observation group was given music relaxation therapy based on Swanson's caring theory. The scores of Medical Coping Modes Questionnaire (MCMQ) and Herth Hope Index (HHI) were compared between the two groups before and after intervention. Results:Before intervention, there were no statistically significant differences in HHI and MCMQ scores between the two groups ( P>0.05) . After the intervention, the HHI score of the observation group was higher than that of the control group, and the difference was statistically significant ( P<0.05) . The face dimension score of the observation group was higher than that of the control group and the yield and avoidance dimension scores were lower than those of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Music relaxation therapy based on Swanson's caring theory can effectively improve the coping style of breast cancer patients and improve their hope level.

Objective:To explore the application effect of ADOPT mode in breast cancer patients with peripherally inserted central catheter (PICC) catheterization.Methods:Using the convenient sampling method, a total of 248 breast cancer patients with PICC catheterization who were admitted to Shanxi Provincial People's Hospital from June 2018 to June 2020 were selected as the research objects. The patients were divided into the observation group ( n=124) and the control group ( n=124) using the random number table method. The patients in the control group were given routine nursing care, while the patients in the observation group were given the ADOPT model on the basis of the nursing care in the control group. The incidence of PICC complications was compared between the two groups. The scores of Exercise of Self-Care Agency Scale (ESCA) , Cancer Fatigue Scale (CFS) and Quality of Life Questionnaire Breast Cancer Module 23 (QLQ-BR 23) were compared between the two groups before and after 3 months of intervention. Results:The number of unplanned extubation cases in the observation group was lower than that in the control group ( P<0.05) . After 3 months of intervention, scores of ESCA and QLQ-BR 23 function scale of the observation group were higher than those of the control group. And the scores of each dimension of the CFS, the QLQ-BR 23 symptom scale and score of the each item were lower than those of the control group, all the differences were statistically significant ( P<0.05) . Conclusions:The ADOPT model has a good effect on reducing the incidence of unplanned extubation in breast cancer patients with PICC catheterization, which can effectively improve the self-care ability and quality of life of patients and relieve cancer fatigue in patients.

Objective:To investigate the effect of 5.8 GHz radiofrequency (RF) radiation on learning and memory along with hippocampal synaptic plasticity in rats, in order to provide theoretical and experimental references for scientific evaluation of potential hazards of 5.8 GHz RF radiation.Methods:A total of 56 healthy adult male Sprague-Dawley rats were randomly divided into sham exposure group ( n=28) and RF exposure group ( n=28). RF groups were exposed to 5.8 GHz RF for 1 h each day in 15 d or 30 d continuously, and the whole-body absorption rate was 1.15 W/kg. The learning and memory ability of rats was tested by Morris water maze (MWM). The hippocampal structure of rats was observed by Nissl stain. The density of dendritic spines in CA1 region of hippocampus was detected by Golgi stain. The expression of synaptic related protein (PSD95, Synaptophysin) in hippocampus was detected by Western blot. The level of hippocampal neurotransmitters was detected by liquid chromatography-mass spectrometry. Results:In MWM experiments, at 15 d and 30 d after RF exposure, there was no statistically significant difference between sham group and RF group in the escape latency, frequency of crossing plateau, percentage of stay time in plateau quadrant and latency of first arrival to the plateau ( P>0.05). Besides, the structure and the number of neurons in the hippocampus, the density of apical and basal dendritic spines of pyramidal neurons in the CA1 region (apical: 5.10±0.20, 4.89±0.24, 4.58±0.27, 4.49±0.24, and basal: 4.81±0.17, 4.79±0.34, 4.20±0.27, 4.22±0.17, named as Sham 15 d group, RF 15 d group, Sham 30 d group, RF 30 d group, respectively), the expression of PSD95 and Synaptophysin and the level of multiple kinds of neurotransmitters in the hippocampus had no significant changes ( P>0.05). Conclusions:In this study, 5.8 GHz RF radiation has no significant influence on the spatial learning and memory ability along with the synaptic plasticity of hippocampal neurons of rats.

Objective To investigate the change of thyroglobulin antibody (TgAb) level in patients with TgAb-positive papillary thyroid carcinoma (PTC),and explore the relationship between the variation of TgAb level and prognosis.Methods A total of 817 PTC postoperative patients (254 males,563 females,median age 45 years) who underwent radioactive iodine therapy (RAI) from February 2008 to December 2014 were retrospectively analyzed.There were 130 patients with TgAb (+),and 687 patients with TgAb (-).The dynamic changes of TgAb in 3 years after RAI were observed,and the threshold value of TgAb reduction rate in predicting recurrence/metastasis was plotted.Mann-Whitney u test,x2 test and receiver operating characteristic(ROC) curve analysis were used to analyze the data.Results There were statistically significant differences in gender,concurrent with Hashimoto thyroiditis (HT),risk stratification and recurrence/metastasis between TgAb (+) and TgAb (-) groups (x2 values:13.988-191.059,z =2.053,all P＜0.05).There were statistically significant differences in tumor size,extrathyroidal extension,risk stratification,TgAb before RAI and concurrent with HT between TgAb (+) patients with and without recurrence/metastasis (x2 values:3.865-6.278;z values:4.624,3.641,all P＜0.05).There were statistically significant differences in tumor size,extrathyroidal extension,risk stratification and TNM staging between TgAb (-) patients with and without recurrence/metastasis (x2 values:13.459,8.215,z values:5.385,3.998;all P＜0.05).For patients with TgAb (+),the optimum cut-off threshold of TgAb reduction rate in predicting recurrence/metastasis by ROC curve analysis at 1,2 and 3 years after RAI was 54.0％,38.0％ and 59.0％,respectively,and the corresponding area under the curve (AUC) was 0.847,0.815 and 0.822,respectively.Conclusions The trend of the TgAb after RAI is related to the prognosis of patients.Patients with TgAb decreased ≥54.0％,≥38.0％,≥59.0％ after 1,2,3 years post-RAI may have better prognosis.

Objective: To explore the association between single nucleotide polymorphism rs12632942 in SCN10A exon and oxaliplatin-induced peripheral neuropathy (OXLIPN) in colorectal cancer (CRC) patients receiving chemotherapy. Methods:Atotal of 319 cases of blood samples from CRC patients receiving chemotherapy regimen with Oxaliplatin (OXL) were collected from the Second Affiliated Hospital of Guangzhou Medical University, the Second Affiliated Hospital of Nanchang University, and Guangzhou Baiyun District Hospital of Chinese Medicine during January 2011 and June 2013. DNAwas routinely extracted, and PCR amplification was performed to analyze the genotype of rs12632942; and OXLIPN of patients was also evaluated. The association between rs12632942 genotype and OXLIPN was analyzed by χ2 test and multivariate logistic regression model. Results: The genotypes of rs12632942 of 319 CRC patients:AAof 134 cases,AG of 156 cases and GG of 29 cases; and the genotype distribution of rs12632942 was in accordance with Hardy-Weinberg equiliberum (P>0.05). χ2 test showed that rs12632942AG+GG genotype was associated with Ⅱ-Ⅳ degree OXLIPN (P<0.01). Multivariate logistic regression model showed that rs12632942 AG + GG genotype was an independent risk factor for Ⅱ-Ⅳ degree OXLIPN（OR=2.044； 95%CI=1.231-3.392; P<0.01） . Conclusion: Colorectal cancer patients with SCN10A exon polymorphism rs12632942AG + GG genotype were susceptible to Ⅱ-Ⅳ degree OXLIPN.