Objective:To investigate the epidemiology of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients with maintenance hemodialysis (MHD) in Jiangsu province during SARS-CoV-2 pandemic in China from December 7, 2022 to January 27, 2023, and to analyze the influencing factors of all-cause death.Methods:It was a multi-center cross-sectional investigation. Structured questionnaire was used to collect patient information by medical staff of each hemodialysis center (room) as investigators. Part of the demography data and laboratory examination data came from the Jiangsu Province Hemodialysis Data Information System. MHD patients from hemodialysis centers (rooms) at all levels of medical institutions and independent hemodialysis institutions in Jiangsu province during the outbreak of SARS-CoV-2 infection were included, and the clinical characteristics and all-cause mortality of confirmed and suspected cases of SARS-CoV-2 infection were analyzed.Results:Questionnaire surveys and data analysis on 57 278 patients in 407 hemodialysis centers (rooms) were completed, accounting for 90.41% of the total number of MHD patients (63 357 cases) in Jiangsu province during the same period. There were 24 038 cases (41.97%) of SARS-CoV-2 infection and 14 805 cases (25.85%) of suspected infection, which were widely distributed in all dialysis centers in Jiangsu province. After clinical classification of 38 843 confirmed and suspected SARS-CoV-2 infection cases, 3 662 cases were severe and critical cases, accounting for 9.43% of the infected and suspected cases. Among the patients who had completed the questionnaires, there were 1 812 all-cause deaths, with an all-cause mortality rate of 3.16%. Multivariate logistic regression analysis showed that elderly (taking ≤50 years as a reference, 51-59 years: OR=1.583, 95% CI 1.279-1.933, P=0.001; 60-69 years: OR=3.972, 95% CI 3.271-4.858, P<0.001; 70-79 years: OR=7.236, 95% CI 5.917-8.698, P<0.001; ≥80 years: OR=11.738, 95% CI 9.459-14.663, P<0.001), male ( OR=1.371, 95% CI 1.229-1.529, P<0.001), and co-infection with hepatitis B virus (HBV) (positive serum HBV surface antigen, OR=0.629, 95% CI 0.484-0.817, P<0.001) were independent influencing factors for all cause mortality. Receiver-operating characteristic curve analysis showed that the area under the curve for male, age and current HBV infection prediction of all-cause death was 0.529 ( P<0.001), 0.724 ( P<0.001) and 0.514 ( P=0.042), respectively, and the cut-off value for age prediction of all-cause death was 65.5 years old. Compared with patients without HBV infection, MHD patients with HBV infection significantly reduced the proportion of severe and critically ill patients, all-cause hospitalizations and all cause deaths when infected with SARS-CoV-2 (4.99% vs. 6.41%, χ2=6.136, P=0.013; 8.90% vs. 11.44%, χ2=11.662, P<0.001; 2.01% vs. 3.37%, χ2=10.713, P=0.001, respectively). Conclusion:The MHD patients in Jiangsu province are susceptible to SARS-CoV-2. Elderly age and male gender are independent risk factors for death in MHD patients during the epidemic, while the HBV infection may be a protective factor for death of MHD patients infected with SARS-CoV-2.

Objective:To construct a recombinant plasmid pET30a-leucine-rich repeat (LRR) containing 15 (LRRC15) of Taenia solium, prokaryotically express and purify the LRRC15 recombinant protein, and prepare a rabbit polyclonal antibody. Methods:The LRRC15 protein encoding gene of Taenia solium was obtained by whole gene synthesis; it was cloned into pET30a vector, and the recombinant plasmid pET30a-LRRC15 was constructed and identified by double-enzyme PCR; the recombinant plasmid was transformed into competent cells of Escherichia coli BL21 (DE3), and the recombinant protein LRRC15 was induced to express by isopropyl-beta-D-thiogalactopyranoside (IPTG), the expression product was analyzed and identified by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE); the LRRC15 recombinant protein was purified by Ni-IDA affinity columns, the purified recombinant protein was analyzed and identified by SDS-PAGE, and the specificity of the purified recombinant protein was identified by Western blot (WB); the New Zealand rabbits were immunized with purified LRRC15 recombinant protein to prepare polyclonal antibodies against LRRC15, and the potency of the purified polyclonal antibody was determined by indirect enzyme-linked immunosorbent assay (ELISA). Results:After PCR identification, a band with a length of 1 506 bp was amplified, which was consistent with the LRRC15 gene; after SDS-PAGE and WB identification, the LRRC15 target protein with a relative molecular mass ( Mr) of about 55.36 × 10 3 was obtained; after immunizing New Zealand rabbits with purified LRRC15 recombinant protein, a polyclonal antibody against LRRC15 was obtained, and its potency was 1∶1 587 200. Conclusion:The recombinant plasmid pET30a-LRRC15 is successfully constructed, the LRRC15 recombinant protein of Taenia solium is prepared, and a high purity and high potency rabbit anti polyclonal antibody against LRRC15 recombinant protein is obtained.

Objective:To investigate the application of diagnostic criteria for common occupational radiation-induced diseases to radiation workers, in order to provide a basis for the revision, publicity and standardization of the standards.Methods:Radiation workers were selected from 1 city, 7 provinces and 1 corporation by using cluster random sampling method from January 2021 to May 2021. Awareness of the criteria and the effects of ionizing radiation, and the suggestions for diagnostic works were investigated and analyzed.Results:A total of 2 839 radiation workers were investigated. There were differences in the awareness of different diagnostic criteria, the inclusions in complex diagnostic criteria, the materials required for applying for diagnosis, and the ways of knowing the diagnostic criteria( χ2=416.06, 2 924.14, 83.45, 895.67, 815.94, P<0.001). The correct understanding rates of deterministic effects and stochastic effects were 80.63% and 43.64%, respectively. The acceptance rates in applicable materials were 96.79% for occupational exposure history, 94.72% for occupational health monitoring records and 93.55% for individual monitoring of occupational exposure, respectively. Pre-employment training rate was 80.20%, on-job training rate was 81.19%, and untrained rate was 3.77%. The suggestions to the diagnosis of occupational radiation-induced diseases are to strengthen training, pay attention to individual monitoring, occupational health examination, and strengthen health supervision and law enforcement. Conclusions:Radiation workers have a low awareness rate of certain diagnostic standards and a high awareness rate of diagnostic procedures. Publicity and training of health effects of ionizing radiation and diagnostic criteria of occupational radiation-induced diseases should be strengthened. Diagnostic procedure should be optimized.

AIM: To investigate the polymorphism distribution of lipid and drug metabolism-related genes of SLCO1B1 and ApoE in patients with cardiovascular disease of Han nationality in Anhui province, and to evaluate the benefit-risk ratio of individual use of statins. METHODS: PCR fluorescence probe technique was used to detect the genetic polymorphism of rs2306283 (388A>G) and rs4149056 (521T>C) of SLCO1B1 as well as rs429358 (388 T>C) and rs7412 (526C>T) of ApoE in 736 individuals diagnosed with cardiovascular diseases in the inpatient department of the Second People's Hospital of Hefei from January 2019 to August 2020 were included. The distribution characteristics of SLCO1B1 and ApoE genotypes were analyzed according to the gender of the subjects, and the results of genetic polymorphism were compared with the data of cardiovascular disease patients in other areas of China. RESULTS: Six genotypes of SLCO1B1 had been detected. They were *1a/*1a (6.11%), *1a/*1b (29.08%), *1b/*1b (44.57%), *1a/*15 (4.08%), *1b/*15 (15.49%) and *15/*15 (0.68%), while *1a/*5, *5/*5 and *5/*15 had not been detected. Six genotypes of ApoE had been detected. They were E2/E2 (0.41%), E2/E3 (11.96%), E2/E4 (1.09%), E3/E3 (67.66%), E3/E4 (17.93%) and E4/E4 (0.95%). The frequency distribution of genetic polymorphism of these two genes satisfied the Hardy-Weinberg genetic equilibrium, which was representative of the population. In this study, the proportion of people with SLCO1B1 normal myopathy risk was the highest, accounting for 79.76%; SLCO1B1 had a lower proportion of people with moderate myopathy risk and high myopathy risk were 19.57% and 0.68%, respectively. The reduced risk, normal risk and increased risk phenotypes of ApoE were respectively 12.37%, 68.75% and 18.88%. There was no statistically significant difference in SLCO1B1 and ApoE genotypes beween gender. Compared with patients with cardiovascular disease in Southern China area, the distribution of ApoE genetic polymorphism was significantly different in Anhui. CONCLUSION: The SLCO1B1 and ApoE genetic polymorphism of 736 patients with cardiovascular diseases in Anhui were mainly normal myopathy risk types with higher dose tolerance of statins as well as popular genotypes that were sensitive to statins, and the application of statins has a lower risk of myopathy and a good effect on lipid reduction. The polymorphism of the two genes was not affected by gender, but the distribution phenotypes of ApoE might be different in regional characteristics. The detection of SLCO1B1 and ApoE genetic polymorphism is significant for evaluation of benefit-risk ratios, thereby guiding statins clinical treatment.

Nurses from all medical environments have close contacts with asthma patients, it can recognize the early indicators of poor asthma control, and provide self-management education and play important roles in the promotion of asthma control. In order to improve the quality of nursing practice in adult asthma control, Registered Nurses＇ Association of Ontario(RNAO) in Canada published the guidelines of Adult Asthma Care: Promoting Control of Asthma (Second Version) in 2017 after summarizing the latest evidence in order to provide systematic guidance. This articles analyzed the suggestions in the nursing practice guidelines and introduce the suggestions from all sections including nursing assessment, planning, implementation and evaluation in nursing practice.

Objective To explore the mediating effect of coping styles on the relationship between social support and self-management among young patients with newly-diagnosed type 2 diabetes(T2DM).Methods A total of 169 young patients with newly-diagnosed T2DM at China-Japan Friendship Hospital were investigated with the Medical Coping Mmodes Questionnaire,Social Support Rating Scale and the Summary of Diabetes Self-Care Activities.Results Among young patients with newly-diagnosed T2DM,there was a positive correlation between social support and confronce coping style(r =0.250,P＜0.01).The confronce coping style was positively correlated with self-management(r=0.367,P＜0.01).Confronce coping style could explain 15.3%variance of self-management(P＜0.01).Confronce coping style had a mediating effect on the relationship between social support and self-management.Conclusions Confronce coping style has a predictive role on self-management among young patients with newly-diagnosed T2DM,and confronce coping style has a mediating effect between social support and self-management.

Objective To discuss the influence of hierarchical management mode on psychological empowerment and innovation behavior of nurses in intensive care unit (ICU). Methods From April 2016 to April 2017, hierarchical management mode was applied among 41 ICU nurses in Shanxi Provincial People's Hospital for 12 months. The levels of psychological empowerment and innovation behavior were compared before intervention, on the 6th and the 12th month after intervention. Results Before the intervention, the score of the psychological empowerment was (3.07±0.46), which was at a middle level. Meanwhile, the score of innovation behavior was (2.91±0.40), which was at a low level. With the implementation of hierarchical management mode, the differences in the scores of each dimension and the total score of psychological empowerment were statistically significant (F=11.463, 27.192, 13.700, 36.609, 45.733;P<0.001). The differences in the scores of each dimension and the total score of innovation behavior were statistically significant (F=43.149, 106.489, 21.836, 80.586;P< 0.001). Conclusions ICU nurses' psychological empowerment is at a moderate level, and individual innovative behavior is at a weak level. Hierarchical management mode helps to improve ICU nurses' psychological empowerment and personal innovative behavior level.

Objective To provide objective evidences for early screening of the hypothalamic-pituitary-adrenal(HPA)axis function in diabetic patients, the relationship between HPA axis function and diabetes mellitus was systematically reviewed. Methods PubMed, Ovid, Embase, Web of science Databases were retrieved from articles reporting the relationship between HPA axis function and diabetes mellitus. Meta-analysis were carried out by Stata 12. 0 software for heterogeneity test and data merged among articles for the inclusion and exclusion criteria. Results Our meta-analysis showed the following results: Compared with control group, the basal plasma cortisol level in total diabetes group, T1DM group, T2DM group, diabetes patients(with or without chronic complications)combined with hypertension was significantly higher. Compared with control group, postdexamethasone cortisol level was markedly higher in diabetes group. There was no significant difference in 24 h urinary free cortisol(24h UFC)and ACTH levels between diabetes group and control group. Our qualitative evaluation shows the following results: the differences of awaking salivary cortisol and cortisol awakening response(CAR)between the two groups were inconsistent among all included studies. Most studies showed that CAR was lower in diabetic patients. Conclusion The present analysis has demonstrated that HPA axis dysfunction exists along with diabetes mellitus, and diabetic comorbidity may further worsen the HPA axis dysfunction.

Objective To investigate the diagnostic value of 64-slice CT angiography (CTA) to head and neck artery pathological changes.Methods One hundred patients with clinical suspicion of head and neck vascular lesions were retrospectively analyzed.Sixty four cases of lesions were detected by 64-slice CTA,and were checked by Digital Subtraction Angiography (DSA) within a week.First,the correlation of 64-slice CTA and DSA diagnosis of head and neck artery stenosis grade was counted.Then DSA was taken as the gold standard.The sensitivity,specificity,positive predictive value,and negative predictive value of 64-slice CTA to diagnose head and neck arteries stenosis were calculated.Results Of 64 cases of patients,2 cases of congenital vascular dysplasia,including 1 case with internal carotid artery in 2 cases,the remaining 60 patients had different degree of stenosis.The sensitivity,specificity,positive predictive value,and negative predictive value of 64-slice CTA was 95.34％,99.48％,97.62％,and 98.98％,respectively.Among 60 narrow patients,the plaque number was 205,including 88 soft plaques,56 mixed plaques,and 61 calcified plaque.Conclusions The 64-silce CTA has multiple advantages including rapid,noninvasiveness,high accuracy and safety,and high application value in the diagnosis of head and neck vascular lesions.It is worth promoting.

Objective Metabolites produced by metabolic imbalance such as free fatty acids and lipopolysaccharides can result in a state of chronic low-grade inflammation, or metabolic inflammation, which plays an important role in the pathogenesis of atherosclerosis, type 2 diabetes, non-alcoholic fatty liver disease, and obesity. The above metabolic disorders are closely related with the metabolic inflammation, which always coexist. Therefore, we proposed the concept ofmetabolic inflammatory syndrome ( MIS). According to our study, patients with two or more metabolic disorders above could be diagnosed as MIS. The current research is aimed to investigate the prevalence of MIS and its components, and to compare the clinical values of MIS and metabolic syndrome ( MS) . Methods 2 001 in patients with type 2 diabetes from 6 hospitals in Shanghai were recruited in the current multi-center cross-sectional study. The diagnostic rates of MIS and MS and their components of both syndromes were compared. Results In the patients with type 2 diabetes, the detective rate of MIS was 96. 2%, which was higher than that of MS (71. 3%). Among 4 components of MIS, atherosclerosis showed the highest detective rate (75.6%). MIS[OR=2.252(95%CI1.026-4.942),P=0.043],atherosclerosis[OR=2.726(95% CI1.953-3. 804),P<0. 001], and MS[OR=1. 915 (95%CI 1. 444-2. 540),P<0. 01] were the risk factors of coronary heart disease. Conclusion With atherosclerosis, type 2 diabetes mellitus, non-alcoholic fatty liver disease, and obesity as its 4 components, MIS has a high detective rate in patients with metabolic disorders, and seems to be more sensitive than MS to distinguish inflammation-related metabolic diseases. The concept of MIS will promote the screening and prevention of atherosclerosis in its early stage.