Peripheral blood indicators in medical radiation workers in Yangpu District of Shanghai， 2017-2019 / 上海预防医学

Objective:To explore the impact of occupational ionizing radiation exposure on blood indicators including white blood cell（ WBC）， red blood cell （RBC）， hemoglobin （Hb）， platelet （PLT） were analyzed. Methods:A total of 237 medical radiation workers in Yangpu district， Shanghai were recruited and divided into observation group and control group， according to individual average dose of external exposure. The annual effective dose in observation group was 0.357 7-4.704 3 mSv， and the median dose was 0.536 8 mSv （0.441 2-0.893 8）. The annual effective dose in control group was 0.031 2-0.350 8 mSv， and the median dose was 0.199 2 mSv （0.143 8-0.252 8）. Routine blood tests were conducted twice in the occupational health examinations from 2017 to 2019 and the results were collected. Chi-square test， Mann-Whitney U test， and generalized estimating equations （GEE） model were used for statistical analysis. Results:Compared to the first examination， the risk of having abnormal Hb increased （OR=1.029， 95%CI： 1.006-1.053）. After adjusting the factors of age， gender， seniority and exposure time， the risk of Hb abnormality in the observation group was lower than that in the control group （OR=0.422， 95%CI：0.198-0.898）. There was no significant difference between the observation and control groups in the risk of abnormal WBC， RBC， and PLT. Conclusion:Exposure to occupational ionizing radiation may increase the risk of abnormal Hb， while there is no significant change in WBC， RBC and PLT. Radiation workers should have full protection at work and be under appropriate occupational health management.

Establishment and validation of risk prediction scoring model of central line-associated bloodstream infection in elderly patients / 中国感染控制杂志

Objective To establish the risk prediction scoring model of central line-associated bloodstream infection (CLABSI) in elderly patients, provide basis for screening high-risk population, and effectively prevent and control bloodstream infection (BSI) in elderly patients.Methods According to the inclusion and exclusion criteria, data of elderly patients who underwent central catheterization during hospitalization from January 1, 2015 to December 31, 2017 were collected, patients were randomly divided into modeling group and verification group according to the ratio of 7∶3 (random seed was 20180708), risk factors of data of modeling group were distinguished, logistic regression model was constructed. The corresponding score of each risk factor was assigned according to β value, infection risk scoring model was established, prediction accuracy of model was evaluated by receiver operating characteristic (ROC) curve; according to the established infection risk scoring model, cases in validation group were scored, prediction accuracy of model was evaluated by ROC curve. Decision curve was constructed using R software.Results Logistic regression analysis showed that the number of operation≥3 times, length of stay in intensive care unit (ICU) ≥2 days, duration of indwelling central venous catheterization≥7 days, and use of antimicrobial agents were independent risk factors for CLABSI in elderly patients; the corresponding points in risk prediction scoring model were 3, 4, 4, and 9 respectively, and the score of 13-17 points were high-risk population of CLABSI; the area of ROC curve (AUC) was 0.74 in the modeling group; ROC curve was plotted based on the risk score of patients in validation group, AUC was 0.70. The decision curve showed that the net benefit of the risk scoring model was higher in the high risk thershold of 0.01-0.05.Conclusion The established risk prediction scoring model has good discriminant validity and application value, and can be used in the identification of susceptible high risk population of CLABSI in elderly patients, so as to achieve early prevention and control.

Imapct of home environment on emotional and behavioral problems in preschool children / 中华疾病控制杂志

Objective To investigate the status of mental health in preschool children of Yangzhou city, and to explore the effect of home environment. Methods A total of 2 531 children from 7 kindergartens were selected by random cluster sampling. Questionnaire (including SDQ tests) was used to analyse the status and characteristics of mental health. Results The rate of children with mental disorder was 6.4%, the most prominent problem was peer relationship difficulty (17.8%), followed by hyperactivity/inattention (13.7%), prosocial behavior (9.4%), conduct problems (7.0%) and emotional problems (5.7%). Except for emotional symptoms, the detection rates of all other investigated problems among boys were higher than those among girls. Logistic regression analysis showed that the low level of mother's education (OR=1.85, 95%CI:1.04-3.29) and the joint family (OR=1.81, 95%CI:1.19-2.75) were risk factors, and gender of girl was protective factor (OR=0.71，95%CI：0.51-0.98). Conclusions The rate of mental disorder is low, but hyperactivity in boys and emotional problems in girls are quite popular, especially in children who have mother with low level of education or live in the joint family.

Economic loss of nosocomial infections in patients with cerebral hemorrhage or cerebral infarction / 中国医学科学院学报

<p><b>OBJECTIVE</b>To evaluate the economic loss of nosocomial infections (NI) in patients with cerebral hemorrhage or cerebral infarction.</p><p><b>METHODS</b>We used case-control method to compare the medical expenses between 46 pairs of cerebral hemorrhage or cerebral infarction patients with or without NI.</p><p><b>RESULTS</b>The median hospital stay, total treatment expense, medications expense, examination expense, and treatment expense of NI were significantly higher in the NI group than in non-NI group (all P < 0.01 ).</p><p><b>CONCLUSIONS</b>NI can prolong hospital stay and increase medical expenses of patients with cerebral hemorrhage or cerebral infarction. Effective measures should be taken to control NI.</p>

Current situation and control strategy of nosocomial infection in intensive care unit / 中国医学科学院学报

Intensive care unit (ICU) is a place with high risk of nosocomial infections. Effective control of nosocomial infections in ICU brings both social and economic benefits. This article summarizes ten main points in the control strategy of ICU infections.

Role of cytokeratin expression in differential diagnosis of intraductal proliferative lesions of breast / 中华病理学杂志

<p><b>OBJECTIVE</b>To evaluate the expression of cytokeratins in intraductal proliferative lesions of breast, including usual ductal hyperplasia (UDH), atypical ductal hyperplasia (ADH), ductal carcinoma-in-situ (DCIS) and its role in differential diagnosis.</p><p><b>METHODS</b>Ninety two cases of paraffin-embedded lesional breast tissue, 30 cases of frozen samples, cell cultures of hyperplastic ductal cells and 2 invasive ductal carcinoma cell lines (T47D and MCF-7) were used for this study. Immunohistochemistry was performed using EnVision method for 34betaE12, CK8 and CK14.</p><p><b>RESULTS</b>The percentage of 34betaE12-positivity in paraffin-embedded samples of UDH, ADH, DCIS and invasive ductal carcinoma (IDC) was found to be 95.2%, 33.3%, 19.2% and 12.5% respectively. In frozen tissues, all UDH cases and 55% of IDC cases expressed 34betaE12. The primary UDH cell cultures and T47D cell line were also 34betaE12-positive, whereas MCF7 cell line showed negative staining. The expression rate of CK8 and CK14 in UDH was also different from that in ADH and DCIS.</p><p><b>CONCLUSIONS</b>34betaE12 can be useful in differential diagnosis of intraductal proliferative lesions of the breast. However application of this cytokeratin stain in intraoperative frozen sections is relatively limited. The expression patterns of CK8 and CK14 are also helpful in the differential diagnosis of similar lesions.</p>

Gene diagnosis of facioscapulohumeral muscular dystrophy / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To observe the characteristics of changes of p13E-11 labelled 4q35 EcoRI fragments and to make a gene diagnosis of facioscapulohumeral muscular dystrophy(FSHD).</p><p><b>METHODS</b>Genomic DNA was extracted and was digested by EcoR I /Bln I. After pulsed field gel electrophoresis, it was hybridized with probe p13E-11 by Southern blot. The illness was diagnosed as FSHD when the 4q35 EcoRI fragment was smaller than 38 kb.</p><p><b>RESULTS</b>In 26 cases of FSHD, the fragments of 20 cases were smaller than 38 kb. The positive rate was 76.92%. In 12 cases of FSHD family members, the fragments of 2 cases were smaller than 38 kb. All fragments of the 21 controls were greater than 38 kb.</p><p><b>CONCLUSION</b>It was rather good to use <38 kb as a standard for diagnosis of FSHD. The positive rate of FSHD was similar to that from the references.</p>