Objective To explore risk factors for cardiac valve calcification (CVC) in maintenance hemodialysis (MHD) patients and evaluate its impact on cardiovascular events and mortality. Methods Retrospective selection of 223 patients with MHD admitted to the Department of Nephrology of Jinshan Hospital, Fudan University from June 30, 2019 to June 30, 2024, and enrollment completed within one week of June 30, 2019. Patients were divided into CVC and non-CVC groups. Baseline data and 5-year follow-up data were collected. The binary logistic regression analysis was performed to explore the risk factors for CVC. Kaplan-Meier survival curve was used to analyze the survival rate of patients. Cox proportional hazard regression model was applied to evaluate the impact of CVC on the survival rates of MHD patients. Results Totally, 223 MHD patients with an average age of (58.4±13.5) years and an average dialysis duration of (64.0±55.4) months were involved. Among them, 136(61.0%) were males, 117(52.5%) were complicated with CVC. Age, dialysis duration, diabetic kidney disease (DKD), the serum corrected total calcium and phosphate, intact parathyroid hormone (iPTH), high-sensitive C-reactive protein (hsCRP), and homocysteine (Hcy) were independent related factors for CVC (P＜0.05). Both all-cause mortality (46.6% vs 28.7%) and cardiovascular mortality (33.3% vs 16.0%) were significantly higher in the CVC group than those in the non-CVC group (P＜0.01). Conclusions Age, dialysis duration, the primary disease, calcium and phosphate, and inflammation- and nutrition-related serum indicators are associated with CVC in MHD patients. CVC significantly increases mortality risk of MHD patients.

In order to facilitate the accurate comprehension and correct implemention of the national occupational health standard Health standard for operators of nuclear power plants (GBZ/T 164-2022), this article presents an in-depth elucidation encompassing the significance of the standard promulgation, the background of its revision, the current status of the relevant domestic and international standards, the basis for revision of the principal technical inclusion and the application scope of the standard. The aim is to provide a guidance the selection, appropriate evaluation, and occupational health monitoring of nuclear power plant operators, ultimately ensuring the safe operation of nuclear facilities.

Objective:To explore the effect of nursing based on the ABC-X model in female facial burn patients.Methods:From January to December 2020, convenience sampling was used to select 70 female facial burn patients admitted to Lishui City People's Hospital as the research object. According to the order of admission, the patients were divided into the control group and the observation group, 35 cases in each group. Patients in the control group were given routine nursing, while the observation group carried out nursing based on the ABC-X model. Self-Rating Anxiety Scale (SAS) , Self-Rating Depression Scale (SDS) , Self-Rating Scale of Body Image and Simple Coping Style Questionnaire were used to evaluate the effect.Results:Before the intervention, there were no significant differences in the scores of SAS, SDS, Self-Rating Scale of Body Image and Simple Coping Style Questionnaire between the two groups ( P>0.05) . After the intervention, the SAS, SDS and Self-Rating Scale of Body Image scores of the observation group were lower than those of the control group, and the differences were statistically significant ( P<0.05) . The positive coping dimension scores of the observation group were higher than those of the control group, and the negative coping dimension scores were lower than those of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Nursing based on the ABC-X model can effectively alleviate negative emotions and body image disorders in female facial burn patients, and improve their coping styles.

Objective To explore the application and early efficacy of modified Veil nerve-sparing technique during laparoscopic radical prostatectomy(LRP).Methods Fifty-seven modified Veil nerve-sparing during LRP procedures were performed in patients with clinically localized prostate cancer between 2012 and 2016 by the same surgeon.Preoperative PSA level was 10.9 μg/ml,and Gleason score was 6.06(5-8).TNM clinical stage showed cT1 in 39 cases and cT2in 18 cases.All patients underwent transrectal ultrasonography before operation. Prostate volume was 40.2 (26- 99) ml. ECT bone scan excluded bone metastasis.MRI or CT examination showed no obvious prostate invasion and lymph node metastasis. The key technology was anatomical separation of detrusor apron, dorsal vascular complex (DVC) and the level between the prostate capsule, and a complete reservation was accomplished. Measurements: the rates and location of positive surgical margins (PSM) and tumor biochemical recurrence rate as well as functional outcomes were presented.Questionnaires were used to assess urine function and IIEF-5 score was used to estimate sexual function.Results Fifty-seven cases were followed up,and the average follow-up of 27.3(6-65)months.Five cases showed biochemical recurrence after 23 months.Five patients had a PSM(2 patients in apical margins,1 patient in left side,1 patient in right side and 1 patient in the bottom).At catheter removal,49 of 57 patients(86%)were dry(0 pads),and 8 of 57 patients(14%)needed one security pad.After 3 months and 6 months,42%(24 of 57 patients)and 60%(34 of 57 patients)presented an International Index of Erectile Function score>15(with or without phospho-diesterasetype-5inhibitors). Conclusions The modified Veil nerve-sparing technique during LRP can retain the fascia around the prostate more completely and restore postoperative urine and erectile function early.For selective cases, it will not increase the positive rate of surgical margins and biochemical recurrence rate.

Objective To analyze the genotype and plasmid transfer of Enterobacteriaceae carring blaNDM‐1 with blaIMP‐4 or blaKPC‐2 .Methods From April 2012 to October 2014 ,a total of 33 non‐repeatitive carbapenem‐resistant Enterobacteriaceae ( including Imipenem‐resistant , meropenem‐resistant or Ertapenem‐resistant) were isolated from 5 hospitals in Wenzhou and Hangzhou . Identification and antimicrobial susceptibility test were performed using Vitek 2 Compact automatic microbiology analyzer . Phenotypes of carbapenemase were screened using modified Hodge test and ethylenediamine tetraacetic acid‐disk synergy test .Extended spectrum βlactamase test was determined by the double disk combination test which was recommended by Clinical and Laboratory Standards Institute .AmpC activity was tested by a three‐dimensional Cefoxitin method .Drug resistant genes including blaNDM‐1 and linkage of ISAba125‐NDM were detected by polymerase chain reaction (PCR) .The purified PCR products were cloned and sequenced .Plasmid conjugation experiment and elimination method were carried out to test partial bacterial strain and K . pneumoniae carrying blaNDM‐1 with blaIMP‐4 or blaKPC‐2 .Results Of the 33 non‐repeatitive carbapenem‐resistant Enterobacteriaceae ,28 were strains of K .pneumoniae ,1 strain of K . oxytoca,2strainsof Escherichiacoli,1strainof K.planticolaand1strainof E.cloacae.Thirteenstrains were isolated from Hospital of Sir Run Run Shaw of Zhejiang University ,thirteen from Wenzhou Hospital of Traditional Chinese Medicine ,one from Wenzhou People′s Hospital ,three from the First Affiliated Hospital of Wenzhou Medical University and three from Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine .Thirty‐one strains were confirmed as carbapenemase‐producing with 24 of blaKPC‐2 ,3 of blaNDM‐1 ,1 of blaNDM‐5 and 3 of blaIMP‐4 .Among them ,one strain carried blaNDM‐1 with blaIMP‐4 and one strain carried blaNDM‐1with blaKPC‐2 ,respectively .The plasmid transfer and conjugation experiment was performed between strains carrying blaNDM‐1 and Escherichia coli EC600 or K . pneumoniae ATCC13833 and genes of blaNDM‐1 and ISAba125‐NDM were obtained .Conclusions blaKPC‐2 gene is the popular carbapenemase genotype .blaNDM‐1 or blaNDM‐5 may be correlated with linkage gene of ISAba125‐N DM .Coexistence of blaNDM‐1 carrying blaIMP‐4 or blaKPC‐2 is detected in the same strain , respectively . Enough importance should be attached to the strains ,because most of them are multiple drug resistance with related genes located in the plasmid which is easily spread between strains .

Objective To investigate voicing changes of adult patients with obstructive sleep apnea hypopnea syndrome (OSAHS) before and after H-uvulopalatopharyngoplasty (H-UPPP). Methods 56 adult OSAHS pa-tients and 40 healthy people were included in the study. Acoustic parameters and formant frequencies were measured for each patient before and after H- UPPP, and also for the control group. Results Acoustic parameters: each group demonstrated no differences in all the parameters except for normalized noised energy (NNE). NNE increased after H-UPPP. Formant frequency: F1, B1, F2, B2, F3 of OSAHS patients were significantly lower than normal control. There was no significant difference in the formant frequency before operation and one week after; however, F1 and F2 were lower than the normal control one week after surgery. One month after surgery, F1 and F2 were ob-viously higher than that obtained in one week. All the other parameters compared with normal controls showed no significant discrepancies. Conclusion Acoustic characteristics of adult OSAHS patients were different from healthy person. After H-UPPP, the vocal tracts of patients changed, thus causing improvement to the acoustic parameters and voicing qualities, especially at the formant frequency. After the surgery, the formant frequencies of the patients increased gradually to the range of healthy people.

In healthy control group(group A),impaired fasting glucose group (group B) and diabetes group(group C),serum ferritin levels gradually raised[(170.7±91.8),(255.2±161.9) and (362.8±298.5) μmol/L].Hemoglobin Was elevated in impaired fasting glucose group,while returned to normal or even lower in diabetes group[group A(141.0±9.5),group B(148.2±11.2),group C(132.3±19.2)g/L].There was no difference in high sensitivity C-reactive protein among the groups.

OBJECTIVE: To study the laryngeal electromyography (LEMG) behaviors of recurrent laryngeal nerve (RLN) paralysis at different time and severity level. METHOD: Eighty-seven cases with RLN paralysis were divided into seven groups according to their paralysis time. Their LEMG behaviors were investigated, and compared with normal. RESULT: (1) Fibrillation potentials and positive sharp wave could be found in injuries thyroarytenoid muscles(TA), posterior cricoarytenoid muscles(PCA), lateral cricoarytenoid muscles(LCA) as early as five days after the onset of paralysis. The denervation potentials increased, and reinnervation potentials appeared from two weeks to three months after the onset. The former became less and the latter increased from 3 months, and the denervation potentials vanished after three years. (2) The recruitment patterns of paralyzed muscles were weak and even there was no interference patterns in them. The amplitude and turns significantly decreased compared with normal control, and the decrease of the turns was more significant. The recruitment potentials of other normal laryngeal muscles increased right after the onset of disease. (3) Evoked potentials (EP) of most paralyzed laryngeal muscles vanished only in some patients, in others there were small and weak EPs, which had a longer latent period and small amplitude. CONCLUSION LEMG is important for the diagnosis and differentiation of RLN paralysis. The denervation potentials and reinnervation potentials are important marks of RLN injury, and closely correlated with the degree and time of RLN injury. The abnormal EP of paralyzed laryngeal muscles could suggest the degree of injury.
Adolescent ; Adult ; Aged ; Case-Control Studies ; Electromyography ; Evoked Potentials ; Female ; Humans ; Male ; Middle Aged ; Recurrent Laryngeal Nerve ; physiopathology ; Vocal Cord Paralysis ; diagnosis ; physiopathology ; Young Adult

OBJECTIVE To investigate drugresistance and clinical distribution characteristics of Staphylococcus strains isolated from inpatients.METHODS The meticillin-resistance and drug-resistance of the Staphylococcus strains isolated from the clinical specimens of the inpatients in our hospital between 2003 and 2005 were tested.RESULTS Totally 768 Staphylococcus strains were mainly isolated from sputum,blood,pus and wound secretion.The main clinical wards were from pediatrics,ICU,tumor chemotherapy departments.The age of these inpatients were mainly over 60 years old(48.7%) and less than 13 years old(33.2%).Two hundred and ninetyStaphylococcus aureus strains(37.8%)and 478 coagulase-negative Staphylococcus strains(62.2%)were included.The isolated rates of meticillin-resistant S.aureus and meticillin-resistant coagulasenegative Staphylococcus were 74.8% and 89.1%,respectively.CONCLUSIONS Infections of Staphylococcus are increased year by year among inpatients.There are high rates of meticillin-resistant strains.It is very important to monitor infections of Staphylococcus,to control the source of infections,to interrupt their spread and to protect impressionable inpatients,in order to prevent infections of Staphylococcus actively.